diff --git a/.gitignore b/.gitignore index f527359..c8de15c 100644 --- a/.gitignore +++ b/.gitignore @@ -1,3 +1,4 @@ .DS_Store data/* .venv +*traces/* \ No newline at end of file diff --git a/claims_analysis/cardinal_care/all_test_case_data.hdf b/claims_analysis/cardinal_care/all_test_case_data.hdf index 5f50392..a908177 100644 --- a/claims_analysis/cardinal_care/all_test_case_data.hdf +++ b/claims_analysis/cardinal_care/all_test_case_data.hdf @@ -1,5 +1,5 @@ %% expected - covered(X) - claim3,claim5,claim6,claim8,claim11,claim12, -%% claim_a1, claim_a2, claim_a3, claim_a4, claim_a6, claim_a9, claim_a11,claim_a14,claim_a17 +%% claim_a1, claim_a2, claim_a3, claim_a4, claim_a6, claim_a9, claim_a11,claim_a14,claim_a17,claim_a18, claim_a21, claim_a24 %% test cases for routine_physical @@ -495,7 +495,7 @@ person.occupation(person_a14,other) person.immunocompromised(person_a14,no) claim.consequence_of_occupation(claim_a14,no) claim.location(claim_a14,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a14,no) +claim.previous_vaccines_flu_more_than_equal_2(claim_a14,no) claim.vaccine_dose_count(claim_a14,2) claim.policy(claim_a15,policy1) @@ -513,7 +513,7 @@ person.occupation(person_a15,other) person.immunocompromised(person_a15,no) claim.consequence_of_occupation(claim_a15,no) claim.location(claim_a15,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a15,yes) +claim.previous_vaccines_flu_more_than_equal_2(claim_a15,yes) claim.vaccine_dose_count(claim_a15,2) claim.policy(claim_a16,policy1) @@ -531,7 +531,7 @@ person.occupation(person_a16,other) person.immunocompromised(person_a16,no) claim.consequence_of_occupation(claim_a16,no) claim.location(claim_a16,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a16,yes) +claim.previous_vaccines_flu_more_than_equal_2(claim_a16,yes) claim.vaccine_dose_count(claim_a16,2) claim.policy(claim_a17,policy1) @@ -549,5 +549,154 @@ person.occupation(person_a17,other) person.immunocompromised(person_a17,no) claim.consequence_of_occupation(claim_a17,no) claim.location(claim_a17,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a17,yes) +claim.previous_vaccines_flu_more_than_equal_2(claim_a17,yes) claim.vaccine_dose_count(claim_a17,1) + + +%% test cases for comprehensive_infertility_services + +%% expected - covered(claim_a18) - yes +%% covered(claim_a19) - no. incorrect cause +%% covered(claim_a20) - no. not covered service +claim.policy(claim_a18,policy_a18) +claim.claimant(claim_a18,person_a18) +policy.insuree(policy_a18,person_a18) +policy.startdate(policy_a18,person_a18,01_08_2023) +policy.enddate(policy_a18,person_a18,30_06_2024) +claim.hosp_start_time(claim_a18,03_09_2023,00_00) +claim.hosp_end_time(claim_a18,03_09_2023,01_13) +claim.hospital(claim_a18,stanford_medical_center) +claim.reason(claim_a18,comprehensive_infertility_services) +person.dob(person_a18,04_02_2023) +person.occupation(person_a18,other) +person.immunocompromised(person_a18,no) +claim.consequence_of_occupation(claim_a18,no) +claim.is_infertile(claim_a18, yes) +claim.had_sterlization(claim_a18, no) +claim.infertility_service(claim_a18, artificial_insemination) +claim.cause_of_infertility(claim_a18, mild_endometriosis) + + +claim.policy(claim_a19,policy_a19) +claim.claimant(claim_a19,person_a19) +policy.insuree(policy_a19,person_a19) +policy.startdate(policy_a19,person_a19,01_08_2023) +policy.enddate(policy_a19,person_a19,30_06_2024) +claim.hosp_start_time(claim_a19,03_09_2023,00_00) +claim.hosp_end_time(claim_a19,03_09_2023,01_13) +claim.hospital(claim_a19,stanford_medical_center) +claim.reason(claim_a19,comprehensive_infertility_services) +person.dob(person_a19,04_02_2023) +person.occupation(person_a19,other) +person.immunocompromised(person_a19,no) +claim.consequence_of_occupation(claim_a19,no) +claim.is_infertile(claim_a19, yes) +claim.had_sterlization(claim_a19, no) +claim.infertility_service(claim_a19, artificial_insemination) +claim.cause_of_infertility(claim_a19, other) + +claim.policy(claim_a20,policy_a20) +claim.claimant(claim_a20,person_a20) +policy.insuree(policy_a20,person_a20) +policy.startdate(policy_a20,person_a20,01_08_2023) +policy.enddate(policy_a20,person_a20,30_06_2024) +claim.hosp_start_time(claim_a20,03_09_2023,00_00) +claim.hosp_end_time(claim_a20,03_09_2023,01_13) +claim.hospital(claim_a20,stanford_medical_center) +claim.reason(claim_a20,comprehensive_infertility_services) +person.dob(person_a20,04_02_2023) +person.occupation(person_a20,other) +person.immunocompromised(person_a20,no) +claim.consequence_of_occupation(claim_a20,no) +claim.is_infertile(claim_a20, yes) +claim.had_sterlization(claim_a20, no) +claim.infertility_service(claim_a20, ivf) +claim.cause_of_infertility(claim_a20, mild_endometriosis) + + +%% test cases for durable_medical_and_surgical_equipment + +%% expected - covered(claim_a21) - yes +%% covered(claim_a22) - no. equipment type not supported by corresponding provider +%% covered(claim_a20) - no. provider not in tier 1 +claim.policy(claim_a21,policy_a21) +claim.claimant(claim_a21,person_a21) +policy.insuree(policy_a21,person_a21) +policy.startdate(policy_a21,person_a21,01_08_2023) +policy.enddate(policy_a21,person_a21,30_06_2024) +claim.hosp_start_time(claim_a21,03_09_2023,00_00) +claim.hosp_end_time(claim_a21,03_09_2023,01_13) +claim.hospital(claim_a21,stanford_medical_center) +claim.reason(claim_a21,durable_medical_and_surgical_equipment) +person.dob(person_a21,04_02_2023) +person.occupation(person_a21,other) +person.immunocompromised(person_a21,no) +claim.consequence_of_occupation(claim_a21,no) +claim.dme_provider(claim_a21, byram_healthcare) +claim.equipment_type(claim_a21, diabetic_testing_supplies) + +claim.policy(claim_a22,policy_a22) +claim.claimant(claim_a22,person_a22) +policy.insuree(policy_a22,person_a22) +policy.startdate(policy_a22,person_a22,01_08_2023) +policy.enddate(policy_a22,person_a22,30_06_2024) +claim.hosp_start_time(claim_a22,03_09_2023,00_00) +claim.hosp_end_time(claim_a22,03_09_2023,01_13) +claim.hospital(claim_a22,stanford_medical_center) +claim.reason(claim_a22,durable_medical_and_surgical_equipment) +person.dob(person_a22,04_02_2023) +person.occupation(person_a22,other) +person.immunocompromised(person_a22,no) +claim.consequence_of_occupation(claim_a22,no) +claim.dme_provider(claim_a22, byram_healthcare) +claim.equipment_type(claim_a22, bipap_supplies) + +claim.policy(claim_a23,policy_a23) +claim.claimant(claim_a23,person_a23) +policy.insuree(policy_a23,person_a23) +policy.startdate(policy_a23,person_a23,01_08_2023) +policy.enddate(policy_a23,person_a23,30_06_2024) +claim.hosp_start_time(claim_a23,03_09_2023,00_00) +claim.hosp_end_time(claim_a23,03_09_2023,01_13) +claim.hospital(claim_a23,stanford_medical_center) +claim.reason(claim_a23,durable_medical_and_surgical_equipment) +person.dob(person_a23,04_02_2023) +person.occupation(person_a23,other) +person.immunocompromised(person_a23,no) +claim.consequence_of_occupation(claim_a23,no) +claim.dme_provider(claim_a23, after_the_fall) +claim.equipment_type(claim_a23, bipap_supplies) + +%% test cases for transplant_travel_and_lodging + +%% expected - covered(claim_a24) - yes +%% covered(claim_a25) - no. recepient not a covered person +claim.policy(claim_a24,policy_a24) +claim.claimant(claim_a24,person_a24) +policy.insuree(policy_a24,person_a24) +policy.startdate(policy_a24,person_a24,01_08_2023) +policy.enddate(policy_a24,person_a24,30_06_2024) +policy.covered_people(policy_a24, [person_a24]) +claim.hosp_start_time(claim_a24,03_09_2023,00_00) +claim.hosp_end_time(claim_a24,03_09_2023,01_13) +claim.hospital(claim_a24,stanford_medical_center) +claim.reason(claim_a24,transplant_travel_and_lodging) +person.dob(person_a24,04_02_2023) +person.occupation(person_a24,other) +person.immunocompromised(person_a24,no) +claim.recipient(claim_a24,person_a24) + +claim.policy(claim_a25,policy_a25) +claim.claimant(claim_a25,person_a25) +policy.insuree(policy_a25,person_a25) +policy.startdate(policy_a25,person_a25,01_08_2023) +policy.enddate(policy_a25,person_a25,30_06_2024) +policy.covered_people(policy_a25, [person_a25]) +claim.hosp_start_time(claim_a25,03_09_2023,00_00) +claim.hosp_end_time(claim_a25,03_09_2023,01_13) +claim.hospital(claim_a25,stanford_medical_center) +claim.reason(claim_a25,transplant_travel_and_lodging) +person.dob(person_a25,04_02_2023) +person.occupation(person_a25,other) +person.immunocompromised(person_a25,no) +claim.recipient(claim_a25,person_a21) \ No newline at end of file diff --git a/claims_analysis/cardinal_care/cardinal_care.hrf b/claims_analysis/cardinal_care/cardinal_care.hrf index 801ca15..06b5287 100644 --- a/claims_analysis/cardinal_care/cardinal_care.hrf +++ b/claims_analysis/cardinal_care/cardinal_care.hrf @@ -50,6 +50,15 @@ eligible_service(C,P,Service):- claim.location(C,L) & valid_location(Service,L). +% service provider and location +eligible_service(C,P,X):- + covered_list_with_service_provider_and_location(List) & + member(X,List) & + claim.service_provider(C,O) & + valid_service_provider(X,O) & + claim.location(C,L) & + valid_location(X,L). + % services that have only location restriction eligible_service(C,P,X):- covered_list_with_location(List) & @@ -57,6 +66,12 @@ eligible_service(C,P,X):- claim.location(C,L) & valid_location(X,L). +% yearly limit +eligible_service(C,P,X):- + covered_list_with_yearly_limit(List) & + member(X,List) & + check_policy_year_limit(C,Service) + % services that have only service provider restriction eligible_service(C,P,X):- covered_list_with_service_provider(List) & @@ -78,7 +93,7 @@ eligible_service(C,P,specialized_screening_counseling):- eligible_service(C,P,specialized_screening_counseling):- claim.screening_type(C,cancer) & claim.cancer_type(C,lung) & - evaluate(countofall(X,lung_cancer_past_twelve_months(C,X)),0). + evaluate(countofall(X,lung_cancer_past_twelve_months(C,X)),1). eligible_service(C,P,specialized_screening_counseling):- claim.screening_type(C,cancer) & @@ -120,6 +135,7 @@ eligible_service(C,P,preventive_care):- claim.vaccine_dose_count(C,D) & leq(D,N). +% https://www.cdc.gov/mmwr/volumes/72/rr/rr7202a1.htm % Not implementing as these are recommendations and not mandatory requirements % LAIV4 should not be used during pregnancy but can be used postpartum. % >= 65: recommend inactivated influenza vaccine (HD-IIV4), quadrivalent recombinant influenza vaccine (RIV4), or quadrivalent adjuvanted inactivated influenza vaccine (aIIV4). @@ -139,29 +155,41 @@ eligible_service(C,P,preventive_care):- leq(D,N). eligible_service(C,P,female_contraceptives):- - claim.claimant(C,Cl) & claim.contraceptive_service(C,Service) & fda_approved(Service) & claim.location(C,L) & contraceptive_location_check(Service,L). -eligible_service(C,P,inpatient_surgical_services):- - claim.location(C,L) & - valid_location(inpatient_surgical_services,L) & - claim.service_provider(C,O) & - valid_service_provider(inpatient_surgical_services, O). - -eligible_service(C,P,outpatient_surgical_services):- - claim.location(C,L) & - valid_location(outpatient_surgical_services,L) & - claim.service_provider(C,O) & - valid_service_provider(outpatient_surgical_services, O). +eligible_service(C,P,transplant_travel_and_lodging):- + claim.recipient(C,Recipient) & + policy.covered_people(P,List) & + member(Recipient,List). + +eligible_service(C,P,comprehensive_infertility_services):- + claim.is_infertile(C,yes) & + claim.had_sterlization(C, no) & + claim.cause_of_infertility(C, Cause) & + valid_infertility_cause_for_artificial_insemination(List) & + member(Cause, List) & + claim.infertility_service(C,artificial_insemination) & + check_policy_year_limit(C,artificial_insemination). +% not covered: injectible_infertility_medication, +% (Part of ART)thawing_frozen_eggs_sperm, donor_charges, surrogacy_charges, gestational_charges, home_kits, ovulation_induction +% IVF, ZIFT, GIFT, cryptopreserved_embryos_transfer_or_service +% https://www.aetna.com/cpb/medical/data/300_399/0327.html + + +eligible_service(C,P,durable_medical_and_surgical_equipment):- + claim.dme_provider(C,Provider) & + tier_one_dme_providers(List) & + member(Provider,List) & + claim.equipment_type(C,Type) & + dme_products(Provider,Products) & + member(Type,Products) & + dme_excluded_list(Excluded) & + ~member(Type, Excluded). -eligible_service(C,P,outpatient_surgery_facility_charges):- - claim.location(C,L) & - valid_location(outpatient_surgery_facility_charges,L). - %%%%%%%%%%%%%%%%%%% Range Limit Checks %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% % Age limits for children are taken from https://www.cdc.gov/vaccines/schedules/hcp/imz/child-schedule-notes.html# % Age limits for adults are taken from https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-schedule-notes.html @@ -373,10 +401,13 @@ lung_cancer_past_twelve_months(Claim1,Claim2):- claim.screening_type(Claim2,cancer) & claim.cancer_type(Claim1,lung) & claim.cancer_type(Claim2,lung) & + claim.time(Claim1,C1_D,C1_T) & + claim.time(Claim2,C2_D,C2_T) & evaluate(parsedate(C1_D),[D,M,Y]) & evaluate(parsedate(C2_D),[D2,M2,Y2]) & - get_date_diff(C1_D, C2_D, Age) & - same(Age, 0) + get_date_diff_in_months(C1_D, C2_D, Months) & + leq(Months,12) & + leq(0, Months). % Count number of visits for a service in the policy year check_policy_year_limit(C,Service):- @@ -460,6 +491,7 @@ yearly_visit_limit(routine_physical,0,22,0). yearly_visit_limit(routine_physical,22,200,1) yearly_visit_limit(gynecological_exam,0,200,1). yearly_visit_limit(home_health_care,0,200,100). +yearly_visit_limit(artificial_insemination,0,200,6) valid_location(routine_physical,phys_office). valid_location(preventive_care,phys_office). @@ -488,6 +520,8 @@ valid_location(home_health_care,home) valid_location(non_surgical_physican_service,hospital) valid_location(well_newborn_nursery_care,hospital) valid_location(well_newborn_nursery_care,birthing_center) +valid_location(inpatient_mental_health,hospital) + contraceptive_location_check(Service, contra_office). contraceptive_location_check(sterilization_surgery_for_women,L). @@ -509,12 +543,27 @@ valid_service_provider(voluntary_sterilization_reversal, specialist_surgeon) valid_screening_list([obesity,healthy_diet,alcohol_drug_misuse,tobacco_missuse,depression,sti, -genetic_risk_cancer_breast_ovarian,stress_management,chronic_condition,lactation,prenatal_postpartum]). -covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) % list of services that are covered with location restrictions + +genetic_risk_cancer_breast_ovarian,stress_management,chronic_condition,lactation,prenatal_postpartum]). +covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care,inpatient_mental_health,outpatient_surgery_facility_charges]) % list of services that are covered with location restrictions + covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) % list of services that are covered with service provider restrictions -covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]). %always covered +covered_list_with_service_provider_and_location([inpatient_surgical_services, outpatient_surgical_services]) % list of services that are covered with service provider restrictions and location restrictions +covered_list([breast_pump_supplies,hospice,skilled_nursing,maternity_care, outpatient_mental_office_visit, outpatient_mental_other_services, advanced_reproductive_technology_care]). %always covered home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]). +% https://www.aetna.com/cpb/medical/data/300_399/0327.html +% a. infertile couples with mild male-factor fertility problems; (when 2 or more semen analyses, measured at least two weeks apart, have 1 or more variables below the 5th percentile) +% b. unexplained infertility problems; +% c. minimal to mild endometriosis; +% d. medically refractory erectile dysfunction or vaginismus preventing intercourse; +% e. couples where the man is HIV positive and undergoing sperm washing; +% f. couples undergoing menotropin ovarian stimulation; or +% g. clomiphene-citrate-stimulated artificial insemination (intra-cervical insemination or IUI) medically necessary for infertile women with WHO Group II ovulation disorders such as polycystic ovarian syndrome who ovulate with clomiphene citrate but have not become pregnant after ovulation induction with clomiphene. +valid_infertility_cause_for_artificial_insemination([mild_male_problems, unexplained, mild_endometriosis, ed_or_vaginismus_preventing, male_hiv_positive, menotropin_stimulation, group_two_disorders]) + + +% From https://www.fda.gov/consumers/free-publications-women/birth-control fda_approved(counseling). fda_approved(rod). fda_approved(larc). @@ -537,6 +586,22 @@ fda_approved(spermicide). fda_approved(levonorgestrel_15_mg). fda_approved(ulipristal_acetate). + +% vendors for dme. Taken from https://vaden.stanford.edu/news/durable-medical-equipment-dme-and-laboratory-benefits-under-cardinal-care +tier_one_dme_providers([byram_healthcare,advanced_diabetes_supply,edgepark_medical,apria]) + +% products by each provider +% https://www.aetna.com/dsepublicContent/assets/pdf/en/DME_National_Provider_Listing.pdf +% https://www.northcoastmed.com/browse-our-products/ + +dme_products(byram_healthcare, [diabetic_testing_supplies, ostomy_supplies, urological_supplies, wound_care, breast_pumps_and_supplies, continuous_glucose_monitors, blood_pressure_monitors ]) +dme_products(advanced_diabetes_supply, [diabetic_testing_supplies, continuous_glucose_monitors, insulin_pumps_and_supplies, insulin, inpen, glucose_meters]) +dme_products(edgepark_medical, [diabetic_testing_supplies, ostomy_supplies, urological_supplies, wound_care, incontinence, insulin_pumps_and_supplies, continuous_glucose_monitors, breast_pumps_and_supplies, pleurx_kits ]) +dme_products(apria, [oxygen_concentrators, ventilators, cpap_supplies, bipap_supplies, ambulatory_aids, hospital_beds, sad_light_boxes, knee_walker ]) + + +dme_excluded_list([whirlpools,portable_whirlpool_pumps,sauna_baths,massage_devices,over_bed_tables,elevators,communication_aids,vision_aids,telephone_alert_systems,personal_hygiene_and_convenience_items]) + %%%%%%%%%%%%%%%%%%% Helper Functions %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% get_timestamp_from_datetime(DATE,TIME,STAMP) :- @@ -583,3 +648,11 @@ minor_or_dependent(C,Cl):- get_date_diff(C_D, DOB, Age) & leq(Age,17). +person.immunocompromised(Cl,Immuno_Status):- + person.condition(Cl,immunocompromised) & + eval(yes, Immuno_Status). + +person.immunocompromised(Cl,Immuno_Status):- + ~person.condition(Cl,immunocompromised) & + eval(no, Immuno_Status). + diff --git a/claims_analysis/cardinal_care/immunization_data_collection_guide.txt b/claims_analysis/cardinal_care/immunization_data_collection_guide.txt index 8213d15..d9e9634 100644 --- a/claims_analysis/cardinal_care/immunization_data_collection_guide.txt +++ b/claims_analysis/cardinal_care/immunization_data_collection_guide.txt @@ -14,6 +14,8 @@ This gives us two pieces of information https://www.cdc.gov/vaccines/schedules/hcp/imz/child-schedule-notes.html#note-hepb - for children and https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-schedule-notes.html#note-hepb - for adults + and + http://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hepb.html for more details I recommend creating a spreadsheet to track limits - for hep_b I used: https://office365stanford-my.sharepoint.com/:x:/r/personal/lalwani_stanford_edu/Documents/vaccine%20schedules.xlsx?d=wba52d2d17a1c4bde9e5cdd104debf400&csf=1&web=1&e=B91e0K&nav=MTVfezAwMDAwMDAwLTAwMDEtMDAwMC0wMDAwLTAwMDAwMDAwMDAwMH0 3. Now, I describe how I derived the rules for the hep-b case. @@ -32,6 +34,10 @@ Persons who are predialysis or on maintenance dialysis Other immunocompromised persons For detailed revaccination recommendations, see http://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hepb.html. +Usually, the detailed recommendations website contains links to both CURRENT and ARCHIVED recommended practices. Please refer to only the CURRENT recommendations. +The documents are usually complex, so it's best to look for something specific. In this case, I specifically searched for the word "revaccination" which helped me find +more detailed eligibility criteria for revaccinations. + After combing through the documents at the above link, I found the following details: - single-dose revaccination for infants born to HBsAg-positive women not responding to the initial vaccine series; - postvaccination serologic testing 1–2 months after the final dose of vaccine is recommended for certain persons following vaccination diff --git a/claims_analysis/cardinal_care/preventive_care_sample_data1.hdf b/claims_analysis/cardinal_care/preventive_care_sample_data1.hdf deleted file mode 100644 index 38b3e84..0000000 --- a/claims_analysis/cardinal_care/preventive_care_sample_data1.hdf +++ /dev/null @@ -1,19 +0,0 @@ -%expected covered(claim1) - yes -claim.policy(claim1,policy1) -policy.type(policy1,cardinal) -claim.claimant(claim1,person1) -policy.insuree(policy1,person1) -claim.hospitalization(claim1,hosp1) -policy.startdate(policy1,person1,01_08_2023) -policy.enddate(policy1,person1,30_06_2024) -hospitalization.start_time(hosp1,02_09_2023,00_00) -hospitalization.end_time(hosp1,02_09_2023,01_13) -hospitalization.hospital(hosp1,stanford_medical_center) -hospitalization.reason(hosp1,preventive_care) -hospitalization.vaccine(hosp1,covid) -hospitalization.location(hosp1,phys_office) -person.dob(person1,01_01_2001) -person.occupation(person1,other) -hospitalization.consequence_of_occupation(hosp1,no) - -claim.time(claim1,01_01_2024,00_00) diff --git a/claims_analysis/cardinal_care/preventive_care_sample_data2.hdf b/claims_analysis/cardinal_care/preventive_care_sample_data2.hdf deleted file mode 100644 index c0e2019..0000000 --- a/claims_analysis/cardinal_care/preventive_care_sample_data2.hdf +++ /dev/null @@ -1,35 +0,0 @@ -%% expected - covered(claim1) - yes -%% covered(claim2) - no -claim.policy(claim1,policy1) -policy.type(policy1,cardinal) -claim.claimant(claim1,person1) -policy.insuree(policy1,person1) -claim.hospitalization(claim1,hosp1) -policy.startdate(policy1,person1,01_08_2023) -policy.enddate(policy1,person1,30_06_2024) -hospitalization.start_time(hosp1,02_09_2023,00_00) -hospitalization.end_time(hosp1,02_09_2023,01_13) -hospitalization.hospital(hosp1,stanford_medical_center) -hospitalization.reason(hosp1,preventive_care) -hospitalization.vaccine(hosp1,tb) -hospitalization.location(hosp1,phys_office) -person.dob(person1,01_01_2001) -person.occupation(person1,other) -hospitalization.consequence_of_occupation(hosp1,no) - -claim.policy(claim2,policy1) -claim.claimant(claim2,person1) -claim.hospitalization(claim2,hosp2) -hospitalization.start_time(hosp2,02_10_2023,00_00) -hospitalization.end_time(hosp2,02_10_2023,01_13) -hospitalization.hospital(hosp2,stanford_medical_center) -hospitalization.reason(hosp2,preventive_care) -hospitalization.vaccine(hosp2,tb) -person.dob(person1,01_01_2001) -person.occupation(person1,other) -hospitalization.consequence_of_occupation(hosp2,no) -hospitalization.location(hosp2,phys_office) - - -claim.time(claim1,01_01_2024,00_00) -claim.time(claim2,01_02_2024,00_00) \ No newline at end of file diff --git a/claims_analysis/cardinal_care/routine_physical_sample_data1.hdf b/claims_analysis/cardinal_care/routine_physical_sample_data1.hdf deleted file mode 100644 index 82eac54..0000000 --- a/claims_analysis/cardinal_care/routine_physical_sample_data1.hdf +++ /dev/null @@ -1,18 +0,0 @@ -%% expected covered(claim1) yes -claim.policy(claim1,policy1) -policy.type(policy1,cardinal) -claim.claimant(claim1,person1) -policy.insuree(policy1,person1) -claim.hospitalization(claim1,hosp1) -policy.startdate(policy1,person1,01_08_2023) -policy.enddate(policy1,person1,30_06_2024) -hospitalization.start_time(hosp1,02_09_2023,00_00) -hospitalization.end_time(hosp1,02_09_2023,01_13) -hospitalization.hospital(hosp1,stanford_medical_center) -hospitalization.reason(hosp1,routine_physical) -hospitalization.location(hosp1,phys_office) -person.dob(person1,01_01_2001) -person.occupation(person1,other) -hospitalization.consequence_of_occupation(hosp1,no) - -claim.time(claim1,01_01_2024,00_00) diff --git a/claims_analysis/cardinal_care/routine_physical_sample_data2.hdf b/claims_analysis/cardinal_care/routine_physical_sample_data2.hdf deleted file mode 100644 index b36bddb..0000000 --- a/claims_analysis/cardinal_care/routine_physical_sample_data2.hdf +++ /dev/null @@ -1,33 +0,0 @@ -%% expected - covered(claim1) - yes -%% covered(claim2) - no -claim.policy(claim1,policy1) -policy.type(policy1,cardinal) -claim.claimant(claim1,person1) -policy.insuree(policy1,person1) -claim.hospitalization(claim1,hosp1) -policy.startdate(policy1,person1,01_08_2023) -policy.enddate(policy1,person1,30_06_2024) -hospitalization.start_time(hosp1,02_09_2023,00_00) -hospitalization.end_time(hosp1,02_09_2023,01_13) -hospitalization.hospital(hosp1,stanford_medical_center) -hospitalization.reason(hosp1,routine_physical) -person.dob(person1,01_01_2001) -person.occupation(person1,other) -hospitalization.consequence_of_occupation(hosp1,no) -hospitalization.location(hosp1,phys_office) - - -claim.policy(claim2,policy1) -claim.claimant(claim2,person1) -claim.hospitalization(claim2,hosp2) -hospitalization.start_time(hosp2,02_08_2023,00_00) -hospitalization.end_time(hosp2,02_08_2023,01_13) -hospitalization.hospital(hosp2,stanford_medical_center) -hospitalization.reason(hosp2,routine_physical) -person.dob(person1,01_01_2001) -hospitalization.consequence_of_occupation(hosp2,no) -hospitalization.location(hosp2,phys_office) - - -claim.time(claim1,01_01_2024,00_00) -claim.time(claim2,01_02_2024,00_00) diff --git a/claims_analysis/cardinal_care/sample_data.hdf b/claims_analysis/cardinal_care/sample_data.hdf deleted file mode 100644 index 82eac54..0000000 --- a/claims_analysis/cardinal_care/sample_data.hdf +++ /dev/null @@ -1,18 +0,0 @@ -%% expected covered(claim1) yes -claim.policy(claim1,policy1) -policy.type(policy1,cardinal) -claim.claimant(claim1,person1) -policy.insuree(policy1,person1) -claim.hospitalization(claim1,hosp1) -policy.startdate(policy1,person1,01_08_2023) -policy.enddate(policy1,person1,30_06_2024) -hospitalization.start_time(hosp1,02_09_2023,00_00) -hospitalization.end_time(hosp1,02_09_2023,01_13) -hospitalization.hospital(hosp1,stanford_medical_center) -hospitalization.reason(hosp1,routine_physical) -hospitalization.location(hosp1,phys_office) -person.dob(person1,01_01_2001) -person.occupation(person1,other) -hospitalization.consequence_of_occupation(hosp1,no) - -claim.time(claim1,01_01_2024,00_00) diff --git a/claims_analysis/cardinal_care/schema.txt b/claims_analysis/cardinal_care/schema.txt index 4ed74dc..8c1c7a7 100644 --- a/claims_analysis/cardinal_care/schema.txt +++ b/claims_analysis/cardinal_care/schema.txt @@ -1,104 +1,221 @@ -Schema +Person +- dob: Date of birth (DD_MM_YYYY) +- occupation + - healthcare_worker + - armed_forces +- dependent + - yes + - no +- condition: Pre-existing medical conditions + - immunocompromised + - hemodialysis_patient -Claim -- Policy -- Date -- Claimant -- hosp_start_time -- hosp_end_time -- Hospital ---- stanford_medical_center ---- menlo_medical_clinic ---- sutter_health -- Location ---- phys_office ---- ob_office ---- gyn_office ---- ob_gyn_office ---- telemedicine ---- sp_office ---- allergy_specialist ---- contra_office ---- birthing_center ---- outpatient_dept ---- surgery_center ---- home ---- hospital -- Reason ---- specialized_screening_counseling ------ cancer ------ obesity,healthy_diet,alcohol_drug_misuse,tobacco_missuse,depression,sti,genetic_risk_cancer_breast_ovarian,stress_management,chronic_condition,lactation,prenatal_postpartum ---- preventive_care ------ flu ------ covid ------ hep_b ---- female_contraceptives ---- routine_physical ---- gynecological_exam ---- physician_consultation ---- breast_pump_supplies ---- physician_consultation ---- allergy ---- inpatient_surgical_services ---- outpatient_surgical_services ---- inpatient_care ---- outpatient_surgery_facility_charges ---- home_health_care ---- non_surgical_physican_service ---- well_newborn_nursery_care ---- abortion ---- voluntary sterilization reversal ---- hospice ---- skilled nursing ---- maternity care -- family_member_present (Family Member or Caregiver Present) -- type_of_care ---- Emergency ---- Non emergency -- mother_hbsag (Mother's HBsAg status for hep_b vaccines) ---- Negative ---- Positive ---- Unknown -- vaccine_brand -- anti_hbs_count (count of anti-HBs in mlU/mL for hep_b vaccines ) --birth_weight (birth weight in grams) -- home_service (Type of service received within home_health_care) ---- transportation ---- homemaker_service ---- home_delivery ---- maintenance_therapy -- service_provider ---- operating_surgeon ---- anesthetist ---- surgical_assistant ---- inpatient_physician ---- outpatient_physician ---- specialist_surgeon -- Vaccine (Type of Vaccine) -- vaccine_dose_count (How many doses of this vaccine have you received, including the current vaccine) -- vaccine_dose_count_annual -- Contraceptive service -- Allegy service -- Contraceptive service -- Allegy service -- Consequence_of_occupation -- screening_type -- cancer_type -- previous_vaccines_pfizer (for covid) -- previous_vaccines_moderna (for covid) -- previous_vaccines_other (for covid, covers janssen and novovax only) -- previous_vaccines_flu_more_than_2 -Person -- DOB -- Occupation -- Sex -- Dependent -- immunocompromised Policy -- Type -- Insuree -- Startdate -- enddate +- type: The type of policy (in this case cardinal) +- insuree: The person who bought the policy +- startdate: Start date of the policy +- enddate: End date of the policy +- covered_people: List of all the people who are covered + + + +Claim +- anti_hbs_count: count of anti-HBs in mlU/mL for hep_b vaccines +- birth_weight: birth weight in grams +- cancer_type: Possible types of cancer + - lung +- cause_of_infertility: Possible causes of infertility (used in comprehensive_infertility_services to determine whether cause is valid for such service or not) + - mild_male_problems + - unexplained + - mild_endometriosis + - ed_or_vaginismus_preventing + - male_hiv_positive + - menotropin_stimulation + - group_two_disorders +- claimant: The claimant. May or may not be same as policy holder +- consequence_of_occupation: Whether the hospitalization was because of work done while performing your occupation duty + - yes + - no +- contraceptive_service: The type of contraceptive_service usedd + - counseling + - rod + - larc + - oral + - iud_with_preogestin + - sterilization_surgery_for_women + - sterilization_surgery_for_men + - implantable_rod + - progestin_shot_injection + - the_pill_estrogen_and_progestin + - the_mini_pill_progestin + - patch + - vaginal_contraceptive_ring + - diaphragm_with_spermicide + - sponge_with_spermicide + - cervical_cap_with_spermicide + - male_condom + - female_condom + - spermicide + - levonorgestrel_15_mg + - ulipristal_acetate +- dme_provider: The provider for the equipments + - byram_healthcare + - advanced_diabetes_supply + - edgepark_medical + - apria +- equipment_type: Type of dme bought + - ambulatory_aids + - bipap_supplies + - blood_pressure_monitors + - breast_pumps_and_supplies + - communication_aids + - continuous_glucose_monitors + - cpap_supplies + - diabetic_testing_supplies + - elevators + - glucose_meters + - hospital_beds + - incontinence + - inpen + - insulin + - insulin_pumps_and_supplies + - knee_walker + - massage_devices + - ostomy_supplies + - over_bed_tables + - oxygen_concentrators + - personal_hygiene_and_convenience_items + - pleurx_kits + - portable_whirlpool_pumps + - sad_light_boxes + - sauna_baths + - telephone_alert_systems + - urological_supplies + - ventilators + - vision_aids + - whirlpools + - wound_care +- family_member_present: Family Member or Caregiver Present +- had_sterlization: Whether the person is sterlized or not. If sterlized, infertility services are not covered + - yes + - no +- home_service: Services provided at home + - transportation + - homemaker_service + - home_delivery + - maintenance_therapy +- hosp_end_time: Hospitalization Start Time +- hosp_start_time: Hospitalization Start Time +- hospital: The hospital where the treatment was done (only have tier 1 for now) + - stanford_medical_center + - menlo_medical_clinic + - sutter_health +- infertility_service: Type of service for infertility (in particular for now only when reason=comprehensive_infertility_services) + - artificial_insemination + - injectible_infertility_medication +- is_infertile: a person is considered infertile if unable to conceive or produce conception after 1 year of frequent sexual intercourse when the female attempting conception is under 35 years of age, or after 6 months of frequent sexual intercourse when the female attempting conception is 35 years of age or older. Alternatively, 6 cycles of timed sperm insemination(s) (intrauterine, intracervical, or intravaginal), either with or without ovulation induction medication, when the female attempting conception is under 35 years of age, or 3 cycles of timed sperm insemination(s) when the female attempting conception is 35 years of age or older + - yes + - no +- location: The office or facility where the treatment was done + - phys_office + - facility + - ob_office + - gyn_office + - ob_gyn_office + - telemedicine + - sp_office + - allergy_specialist + - contra_office + - birthing_center + - outpatient_dept + - surgery_center + - home + - hospital +- mother_hbsag: Mother's HBsAg status for hep_b vaccines. Possible Values: + - negative + - positive + - unknown +- policy: policy to which the claim is related to +- previous_vaccines_flu_more_than_equal_2: If atleast 2 flu vaccine shots have been taken + - yes + - no +- previous_vaccines_moderna: Number of moderna vaccines taken (for covid) +- previous_vaccines_other: Number of other vaccines taken (for covid, covers janssen and novovax only) +- previous_vaccines_pfizer: Number of pfizer vaccine taken (for covid) +- reason: Broad category of the type of service received. This in most cases, map directly to service mentioned in the policy document + - specialized_screening_counseling + - preventive_care + - female_contraceptives + - routine_physical + - gynecological_exam + - physician_consultation + - allergy + - breast_pump_supplies + - physician_consultation + - abortion + - inpatient_surgical_services + - outpatient_surgical_services + - inpatient_care + - outpatient_surgery_facility_charges + - home_health_care + - non_surgical_physican_service + - transplant_travel_and_lodging + - comprehensive_infertility_services + - inpatient_mental_health + - outpatient_mental_office_visit + - outpatient_mental_other_services + - comprehensive_infertility_services + - advanced_reproductive_technology_care + - well_newborn_nursery_care + - voluntary_sterilization_reversal + - hospice + - skilled_nursing + - maternity_care + - durable_medical_and_surgical_equipment +- recipient: In transplant, the person who is receiving the organ +- screening_type: The type of disease screening + - cancer + - obesity + - healthy_diet + - alcohol_drug_misuse + - tobacco_missuse + - depression + - sti + - genetic_risk_cancer_breast_ovarian + - stress_management + - chronic_condition + - lactation + - prenatal_postpartum +- service_provider: The possible doctor/specialist/practitioner for the service (used for surgical processes, abortion and sterlization) + - operating_surgeon + - anesthetist + - surgical_assistant + - operating_surgeon + - anesthetist + - surgical_assistant + - inpatient_physician + - outpatient_physician + - specialist_surgeon + - inpatient_physician + - outpatient_physician + - specialist_surgeon +- time: The date and time at which claim is filed +- type_of_care: Whether it is an emergency or not + - emergency + - non_emergency +- vaccine: which vaccine was given + - hep_b + - covid + - flu +- vaccine_brand: The brand of vaccine taken + - twinrix + - pfizer + - moderna + - janssen + - novavax +- vaccine_dose_count: Total Vaccine doses taken by the person (for covid and hep_b) +- vaccine_dose_count_annual: Vaccine doses taken by the person in the last year (for flu) + diff --git a/claims_analysis/cardinal_care/test_cases/test_cases_contraceptives.hdf b/claims_analysis/cardinal_care/test_cases/test_cases_contraceptives.hdf index 535af62..7a5521b 100644 --- a/claims_analysis/cardinal_care/test_cases/test_cases_contraceptives.hdf +++ b/claims_analysis/cardinal_care/test_cases/test_cases_contraceptives.hdf @@ -14,7 +14,7 @@ person.occupation(person14,other) claim.consequence_of_occupation(claim14,no) claim.location(claim14,contra_office) claim.time(claim14,01_01_2024,00_00) -claim.contraceptive_service(C,iud_with_progestin) +claim.contraceptive_service(claim14,iud_with_preogestin) claim.policy(claim15,policy1) policy.type(policy1,cardinal) @@ -31,7 +31,7 @@ person.occupation(person15,other) claim.consequence_of_occupation(claim15,no) claim.location(claim15,contra_office) claim.time(claim15,01_01_2024,00_00) -claim.contraceptive_service(C,other) +claim.contraceptive_service(claim15,other) claim.policy(claim16,policy1) policy.type(policy1,cardinal) @@ -48,4 +48,4 @@ person.occupation(person16,other) claim.consequence_of_occupation(claim16,no) claim.location(claim16,hospital) claim.time(claim16,01_01_2024,00_00) -claim.contraceptive_service(C,iud_with_progestin) \ No newline at end of file +claim.contraceptive_service(claim16,iud_with_preogestin) \ No newline at end of file diff --git a/claims_analysis/cardinal_care/test_cases/test_cases_flu.hdf b/claims_analysis/cardinal_care/test_cases/test_cases_flu.hdf index f567576..aa0d8ea 100644 --- a/claims_analysis/cardinal_care/test_cases/test_cases_flu.hdf +++ b/claims_analysis/cardinal_care/test_cases/test_cases_flu.hdf @@ -15,8 +15,8 @@ person.occupation(person_a14,other) person.immunocompromised(person_a14,no) claim.consequence_of_occupation(claim_a14,no) claim.location(claim_a14,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a14,no) -claim.vaccine_dose_count(claim_a14,2) +claim.previous_vaccines_flu_more_than_equal_2(claim_a14,no) +claim.vaccine_dose_count_annual(claim_a14,2) claim.policy(claim_a15,policy1) claim.claimant(claim_a15,person_a15) @@ -33,8 +33,8 @@ person.occupation(person_a15,other) person.immunocompromised(person_a15,no) claim.consequence_of_occupation(claim_a15,no) claim.location(claim_a15,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a15,yes) -claim.vaccine_dose_count(claim_a15,2) +claim.previous_vaccines_flu_more_than_equal_2(claim_a15,yes) +claim.vaccine_dose_count_annual(claim_a15,2) claim.policy(claim_a16,policy1) claim.claimant(claim_a16,person_a16) @@ -51,8 +51,8 @@ person.occupation(person_a16,other) person.immunocompromised(person_a16,no) claim.consequence_of_occupation(claim_a16,no) claim.location(claim_a16,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a16,yes) -claim.vaccine_dose_count(claim_a16,2) +claim.previous_vaccines_flu_more_than_equal_2(claim_a16,yes) +claim.vaccine_dose_count_annual(claim_a16,2) claim.policy(claim_a17,policy1) claim.claimant(claim_a17,person_a17) @@ -69,5 +69,5 @@ person.occupation(person_a17,other) person.immunocompromised(person_a17,no) claim.consequence_of_occupation(claim_a17,no) claim.location(claim_a17,phys_office) -claim.previous_vaccines_flu_more_than_2(claim_a17,yes) -claim.vaccine_dose_count(claim_a17,1) +claim.previous_vaccines_flu_more_than_equal_2(claim_a17,yes) +claim.vaccine_dose_count_annual(claim_a17,1) diff --git a/claims_analysis/cardinal_care/test_cases/test_cases_specialized_screening.hdf b/claims_analysis/cardinal_care/test_cases/test_cases_specialized_screening.hdf new file mode 100644 index 0000000..d582a82 --- /dev/null +++ b/claims_analysis/cardinal_care/test_cases/test_cases_specialized_screening.hdf @@ -0,0 +1,70 @@ +%% expected result - [claim14, claim17] +claim.policy(claim14,policy1) +policy.type(policy1,cardinal) +claim.claimant(claim14,person14) +policy.insuree(policy1,person14) +policy.startdate(policy1,person14,01_08_2023) +policy.enddate(policy1,person14,30_06_2024) +claim.hosp_start_time(claim14,02_09_2023,00_00) +claim.hosp_end_time(claim14,02_09_2023,01_13) +claim.hospital(claim14,stanford_medical_center) +claim.reason(claim14,specialized_screening_counseling) +claim.screening_type(claim14,obesity) +person.dob(person14,01_01_2001) +person.occupation(person14,other) +claim.consequence_of_occupation(claim14,no) +claim.location(claim14,contra_office) +claim.time(claim14,01_01_2024,00_00) + +claim.policy(claim15,policy1) +policy.type(policy1,cardinal) +claim.claimant(claim15,person15) +policy.insuree(policy1,person15) +policy.startdate(policy1,person15,01_08_2023) +policy.enddate(policy1,person15,30_06_2024) +claim.hosp_start_time(claim15,02_09_2023,00_00) +claim.hosp_end_time(claim15,02_09_2023,01_13) +claim.hospital(claim15,stanford_medical_center) +claim.reason(claim15,specialized_screening_counseling) +person.dob(person15,01_01_2001) +person.occupation(person15,other) +claim.consequence_of_occupation(claim15,no) +claim.location(claim15,contra_office) +claim.screening_type(claim15,tomfoolery) +claim.time(claim15,01_01_2024,00_00) + +claim.policy(claim16,policy1) +policy.type(policy1,cardinal) +claim.claimant(claim16,person15) +policy.insuree(policy1,person15) +policy.startdate(policy1,person15,01_08_2023) +policy.enddate(policy1,person15,30_06_2024) +claim.hosp_start_time(claim16,02_09_2023,00_00) +claim.hosp_end_time(claim16,02_09_2023,01_13) +claim.hospital(claim16,stanford_medical_center) +claim.reason(claim16,specialized_screening_counseling) +person.dob(person15,01_01_2001) +person.occupation(person15,other) +claim.consequence_of_occupation(claim16,no) +claim.location(claim16,contra_office) +claim.screening_type(claim16,cancer) +claim.cancer_type(claim16,lung) +claim.time(claim16,01_03_2024,00_00) + +claim.policy(claim17,policy1) +policy.type(policy1,cardinal) +claim.claimant(claim17,person15) +policy.insuree(policy1,person15) +policy.startdate(policy1,person15,01_08_2023) +policy.enddate(policy1,person15,30_06_2024) +claim.hosp_start_time(claim17,02_09_2023,00_00) +claim.hosp_end_time(claim17,02_09_2023,01_13) +claim.hospital(claim17,stanford_medical_center) +claim.reason(claim17,specialized_screening_counseling) +person.dob(person15,01_01_2001) +person.occupation(person15,other) +claim.consequence_of_occupation(claim17,no) +claim.location(claim17,contra_office) +claim.screening_type(claim17,cancer) +claim.cancer_type(claim17,lung) +claim.time(claim17,01_01_2024,00_00) \ No newline at end of file diff --git a/claims_analysis/cardinal_care/traces/debug1.txt b/claims_analysis/cardinal_care/traces/debug1.txt index 4d64f7e..b0b9f19 100644 --- a/claims_analysis/cardinal_care/traces/debug1.txt +++ b/claims_analysis/cardinal_care/traces/debug1.txt @@ -1,50 +1,12155 @@ ============ BEGIN CARDINAL CARE TESTS ============ -Expected Result: null +Expected Result: [ 'claim14' ] Call: covered(X) | Call: claim.policy(X,V1) -| Exit: claim.policy(claim5,policy1) +| Exit: claim.policy(claim14,policy1) | Call: policy.type(policy1,V2) | Exit: policy.type(policy1,cardinal) -| Call: covered_under_policy(claim5,policy1,cardinal) -| | Call: valid_insuree(claim5,policy1) -| | | Call: claim.claimant(claim5,V3) -| | | Exit: claim.claimant(claim5,person3) -| | | Call: policy.insuree(policy1,person3) -| | | Exit: policy.insuree(policy1,person3) +| Call: covered_under_policy(claim14,policy1,cardinal) +| | Call: valid_insuree(claim14,policy1) +| | | Call: claim.claimant(claim14,V3) +| | | Exit: claim.claimant(claim14,person14) +| | | Call: policy.insuree(policy1,person14) +| | | Exit: policy.insuree(policy1,person14) | | Exit: valid_insuree(C,P) -| | Call: policy_active(claim5,policy1) -| | | Call: claim.claimant(claim5,V4) -| | | Exit: claim.claimant(claim5,person3) -| | | Call: claim.hosp_start_time(claim5,V5,V6) -| | | Exit: claim.hosp_start_time(claim5,02_09_2023,00_00) -| | | Call: claim.hosp_end_time(claim5,V7,V8) -| | | Exit: claim.hosp_end_time(claim5,02_09_2023,01_13) -| | | Call: policy.startdate(policy1,person3,V9) -| | | Exit: policy.startdate(policy1,person3,01_08_2023) -| | | Call: policy.enddate(policy1,person3,V10) -| | | Exit: policy.enddate(policy1,person3,30_06_2024) +| | Call: policy_active(claim14,policy1) +| | | Call: claim.claimant(claim14,V4) +| | | Exit: claim.claimant(claim14,person14) +| | | Call: claim.hosp_start_time(claim14,V5,V6) +| | | Exit: claim.hosp_start_time(claim14,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim14,V7,V8) +| | | Exit: claim.hosp_end_time(claim14,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person14,V9) +| | | Exit: policy.startdate(policy1,person14,01_08_2023) +| | | Call: policy.enddate(policy1,person14,V10) +| | | Exit: policy.enddate(policy1,person14,30_06_2024) | | | Call: get_timestamp_from_date(02_09_2023,V11) | | | | Call: evaluate(parsedate(02_09_2023),[V12,V13,V14]) | | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) -| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V11) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V11) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V15) +| | | | Call: evaluate(parsedate(02_09_2023),[V16,V17,V18]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V15) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V19) +| | | | Call: evaluate(parsedate(30_06_2024),[V20,V21,V22]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V19) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V23) +| | | | Call: evaluate(parsedate(01_08_2023),[V24,V25,V26]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V23) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim14,policy1) +| | | Call: claim.hospital(claim14,V27) +| | | Exit: claim.hospital(claim14,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim14,V28) +| | | Exit: claim.reason(claim14,female_contraceptives) +| | | Call: eligible_service(claim14,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim14,female_contraceptives) +| | | | | Call: claim.claimant(claim14,V29) +| | | | | Exit: claim.claimant(claim14,person14) +| | | | | Call: person.dob(person14,V30) +| | | | | Exit: person.dob(person14,01_01_2001) +| | | | | Call: claim.time(claim14,V31,V32) +| | | | | Exit: claim.time(claim14,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V33) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V34,V35,V36]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V37,V38,V39]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V40) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V41) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V42) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V43) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V33) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V44) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V45,V46,V44) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V45,V46,V44) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V44) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V33) +| | | | | Redo: claim.time(claim14,V31,V32) +| | | | | Fail: claim.time(claim14,V31,V32) +| | | | | Redo: person.dob(person14,V30) +| | | | | Fail: person.dob(person14,V30) +| | | | | Redo: claim.claimant(claim14,V29) +| | | | | Fail: claim.claimant(claim14,V29) +| | | | Fail: check_policy_year_limit(claim14,female_contraceptives) +| | | | Call: covered_list_with_location(V47) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V47) +| | | | Fail: covered_list_with_location(V47) +| | | | Call: covered_list_with_service_provider(V48) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V48) +| | | | Fail: covered_list_with_service_provider(V48) +| | | | Call: covered_list(V49) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V49) +| | | | Fail: covered_list(V49) +| | | | Call: claim.claimant(claim14,V50) +| | | | Exit: claim.claimant(claim14,person14) +| | | | Call: claim.contraceptive_service(claim14,V51) +| | | | Exit: claim.contraceptive_service(claim14,iud_with_preogestin) +| | | | Call: fda_approved(iud_with_preogestin) +| | | | Exit: fda_approved(iud_with_preogestin) +| | | | Call: claim.location(claim14,V52) +| | | | Exit: claim.location(claim14,contra_office) +| | | | Call: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Exit: contraceptive_location_check(Service,contra_office) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim14,policy1) +Call: exception(claim14,policy1) +| Call: claim.claimant(claim14,V53) +| Exit: claim.claimant(claim14,person14) +| Call: person.occupation(person14,armed_forces) +| Fail: person.occupation(person14,armed_forces) +| Redo: claim.claimant(claim14,V53) +| Fail: claim.claimant(claim14,V53) +| Call: claim.reason(claim14,home_health_care) +| Fail: claim.reason(claim14,home_health_care) +| Call: claim.reason(claim14,home_health_care) +| Fail: claim.reason(claim14,home_health_care) +Fail: exception(claim14,policy1) +| | | Exit: ~exception(claim14,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim14) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Fail: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Redo: claim.location(claim14,V52) +| | | | Fail: claim.location(claim14,V52) +| | | | Redo: fda_approved(iud_with_preogestin) +| | | | Fail: fda_approved(iud_with_preogestin) +| | | | Redo: claim.contraceptive_service(claim14,V51) +| | | | Fail: claim.contraceptive_service(claim14,V51) +| | | | Redo: claim.claimant(claim14,V50) +| | | | Fail: claim.claimant(claim14,V50) +| | | Fail: eligible_service(claim14,policy1,female_contraceptives) +| | | Redo: claim.reason(claim14,V28) +| | | Fail: claim.reason(claim14,V28) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim14,V27) +| | | Fail: claim.hospital(claim14,V27) +| | | Call: claim.reason(claim14,emergency_room) +| | | Fail: claim.reason(claim14,emergency_room) +| | Fail: valid_hospitalization(claim14,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V23) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V19) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V15) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V11) +| | | Redo: policy.enddate(policy1,person14,V10) +| | | Fail: policy.enddate(policy1,person14,V10) +| | | Redo: policy.startdate(policy1,person14,V9) +| | | Fail: policy.startdate(policy1,person14,V9) +| | | Redo: claim.hosp_end_time(claim14,V7,V8) +| | | Fail: claim.hosp_end_time(claim14,V7,V8) +| | | Redo: claim.hosp_start_time(claim14,V5,V6) +| | | Fail: claim.hosp_start_time(claim14,V5,V6) +| | | Redo: claim.claimant(claim14,V4) +| | | Fail: claim.claimant(claim14,V4) +| | Fail: policy_active(claim14,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person14) +| | | Fail: policy.insuree(policy1,person14) +| | | Redo: claim.claimant(claim14,V3) +| | | Fail: claim.claimant(claim14,V3) +| | Fail: valid_insuree(claim14,policy1) +| Fail: covered_under_policy(claim14,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim14,policy1,cardinal) +| | Call: valid_insuree(claim14,policy1) +| | | Call: claim.claimant(claim14,V54) +| | | Exit: claim.claimant(claim14,person14) +| | | Call: policy.insuree(policy1,person14) +| | | Exit: policy.insuree(policy1,person14) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim14,policy1) +| | | Call: claim.claimant(claim14,V55) +| | | Exit: claim.claimant(claim14,person14) +| | | Call: claim.hosp_start_time(claim14,V56,V57) +| | | Exit: claim.hosp_start_time(claim14,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim14,V58,V59) +| | | Exit: claim.hosp_end_time(claim14,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person14,V60) +| | | Exit: policy.startdate(policy1,person14,01_08_2023) +| | | Call: policy.enddate(policy1,person14,V61) +| | | Exit: policy.enddate(policy1,person14,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V62) +| | | | Call: evaluate(parsedate(02_09_2023),[V63,V64,V65]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V62) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V66) +| | | | Call: evaluate(parsedate(02_09_2023),[V67,V68,V69]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V66) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V70) +| | | | Call: evaluate(parsedate(30_06_2024),[V71,V72,V73]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V70) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V74) +| | | | Call: evaluate(parsedate(01_08_2023),[V75,V76,V77]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V74) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim14,policy1) +| | | Call: claim.hospital(claim14,V78) +| | | Exit: claim.hospital(claim14,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim14,V79) +| | | Exit: claim.reason(claim14,female_contraceptives) +| | | Call: eligible_service(claim14,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim14,female_contraceptives) +| | | | | Call: claim.claimant(claim14,V80) +| | | | | Exit: claim.claimant(claim14,person14) +| | | | | Call: person.dob(person14,V81) +| | | | | Exit: person.dob(person14,01_01_2001) +| | | | | Call: claim.time(claim14,V82,V83) +| | | | | Exit: claim.time(claim14,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V84) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V85,V86,V87]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V88,V89,V90]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V91) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V92) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V93) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V94) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V84) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V95) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V96,V97,V95) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V96,V97,V95) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V95) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V84) +| | | | | Redo: claim.time(claim14,V82,V83) +| | | | | Fail: claim.time(claim14,V82,V83) +| | | | | Redo: person.dob(person14,V81) +| | | | | Fail: person.dob(person14,V81) +| | | | | Redo: claim.claimant(claim14,V80) +| | | | | Fail: claim.claimant(claim14,V80) +| | | | Fail: check_policy_year_limit(claim14,female_contraceptives) +| | | | Call: covered_list_with_location(V98) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V98) +| | | | Fail: covered_list_with_location(V98) +| | | | Call: covered_list_with_service_provider(V99) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V99) +| | | | Fail: covered_list_with_service_provider(V99) +| | | | Call: covered_list(V100) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V100) +| | | | Fail: covered_list(V100) +| | | | Call: claim.claimant(claim14,V101) +| | | | Exit: claim.claimant(claim14,person14) +| | | | Call: claim.contraceptive_service(claim14,V102) +| | | | Exit: claim.contraceptive_service(claim14,iud_with_preogestin) +| | | | Call: fda_approved(iud_with_preogestin) +| | | | Exit: fda_approved(iud_with_preogestin) +| | | | Call: claim.location(claim14,V103) +| | | | Exit: claim.location(claim14,contra_office) +| | | | Call: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Exit: contraceptive_location_check(Service,contra_office) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim14,policy1) +Call: exception(claim14,policy1) +| Call: claim.claimant(claim14,V104) +| Exit: claim.claimant(claim14,person14) +| Call: person.occupation(person14,armed_forces) +| Fail: person.occupation(person14,armed_forces) +| Redo: claim.claimant(claim14,V104) +| Fail: claim.claimant(claim14,V104) +| Call: claim.reason(claim14,home_health_care) +| Fail: claim.reason(claim14,home_health_care) +| Call: claim.reason(claim14,home_health_care) +| Fail: claim.reason(claim14,home_health_care) +Fail: exception(claim14,policy1) +| | | Exit: ~exception(claim14,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim14) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Fail: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Redo: claim.location(claim14,V103) +| | | | Fail: claim.location(claim14,V103) +| | | | Redo: fda_approved(iud_with_preogestin) +| | | | Fail: fda_approved(iud_with_preogestin) +| | | | Redo: claim.contraceptive_service(claim14,V102) +| | | | Fail: claim.contraceptive_service(claim14,V102) +| | | | Redo: claim.claimant(claim14,V101) +| | | | Fail: claim.claimant(claim14,V101) +| | | Fail: eligible_service(claim14,policy1,female_contraceptives) +| | | Redo: claim.reason(claim14,V79) +| | | Fail: claim.reason(claim14,V79) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim14,V78) +| | | Fail: claim.hospital(claim14,V78) +| | | Call: claim.reason(claim14,emergency_room) +| | | Fail: claim.reason(claim14,emergency_room) +| | Fail: valid_hospitalization(claim14,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V74) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V70) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V66) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V62) +| | | Redo: policy.enddate(policy1,person14,V61) +| | | Fail: policy.enddate(policy1,person14,V61) +| | | Redo: policy.startdate(policy1,person14,V60) +| | | Fail: policy.startdate(policy1,person14,V60) +| | | Redo: claim.hosp_end_time(claim14,V58,V59) +| | | Fail: claim.hosp_end_time(claim14,V58,V59) +| | | Redo: claim.hosp_start_time(claim14,V56,V57) +| | | Fail: claim.hosp_start_time(claim14,V56,V57) +| | | Redo: claim.claimant(claim14,V55) +| | | Fail: claim.claimant(claim14,V55) +| | Fail: policy_active(claim14,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person14) +| | | Fail: policy.insuree(policy1,person14) +| | | Redo: claim.claimant(claim14,V54) +| | | Fail: claim.claimant(claim14,V54) +| | Fail: valid_insuree(claim14,policy1) +| Fail: covered_under_policy(claim14,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim14,policy1,cardinal) +| | Call: valid_insuree(claim14,policy1) +| | | Call: claim.claimant(claim14,V105) +| | | Exit: claim.claimant(claim14,person14) +| | | Call: policy.insuree(policy1,person14) +| | | Exit: policy.insuree(policy1,person14) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim14,policy1) +| | | Call: claim.claimant(claim14,V106) +| | | Exit: claim.claimant(claim14,person14) +| | | Call: claim.hosp_start_time(claim14,V107,V108) +| | | Exit: claim.hosp_start_time(claim14,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim14,V109,V110) +| | | Exit: claim.hosp_end_time(claim14,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person14,V111) +| | | Exit: policy.startdate(policy1,person14,01_08_2023) +| | | Call: policy.enddate(policy1,person14,V112) +| | | Exit: policy.enddate(policy1,person14,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V113) +| | | | Call: evaluate(parsedate(02_09_2023),[V114,V115,V116]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V113) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V117) +| | | | Call: evaluate(parsedate(02_09_2023),[V118,V119,V120]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V117) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V121) +| | | | Call: evaluate(parsedate(30_06_2024),[V122,V123,V124]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V121) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V125) +| | | | Call: evaluate(parsedate(01_08_2023),[V126,V127,V128]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V125) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim14,policy1) +| | | Call: claim.hospital(claim14,V129) +| | | Exit: claim.hospital(claim14,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim14,V130) +| | | Exit: claim.reason(claim14,female_contraceptives) +| | | Call: eligible_service(claim14,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim14,female_contraceptives) +| | | | | Call: claim.claimant(claim14,V131) +| | | | | Exit: claim.claimant(claim14,person14) +| | | | | Call: person.dob(person14,V132) +| | | | | Exit: person.dob(person14,01_01_2001) +| | | | | Call: claim.time(claim14,V133,V134) +| | | | | Exit: claim.time(claim14,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V135) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V136,V137,V138]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V139,V140,V141]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V142) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V143) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V144) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V145) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V135) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V146) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V147,V148,V146) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V147,V148,V146) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V146) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V135) +| | | | | Redo: claim.time(claim14,V133,V134) +| | | | | Fail: claim.time(claim14,V133,V134) +| | | | | Redo: person.dob(person14,V132) +| | | | | Fail: person.dob(person14,V132) +| | | | | Redo: claim.claimant(claim14,V131) +| | | | | Fail: claim.claimant(claim14,V131) +| | | | Fail: check_policy_year_limit(claim14,female_contraceptives) +| | | | Call: covered_list_with_location(V149) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V149) +| | | | Fail: covered_list_with_location(V149) +| | | | Call: covered_list_with_service_provider(V150) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V150) +| | | | Fail: covered_list_with_service_provider(V150) +| | | | Call: covered_list(V151) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V151) +| | | | Fail: covered_list(V151) +| | | | Call: claim.claimant(claim14,V152) +| | | | Exit: claim.claimant(claim14,person14) +| | | | Call: claim.contraceptive_service(claim14,V153) +| | | | Exit: claim.contraceptive_service(claim14,iud_with_preogestin) +| | | | Call: fda_approved(iud_with_preogestin) +| | | | Exit: fda_approved(iud_with_preogestin) +| | | | Call: claim.location(claim14,V154) +| | | | Exit: claim.location(claim14,contra_office) +| | | | Call: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Exit: contraceptive_location_check(Service,contra_office) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim14,policy1) +Call: exception(claim14,policy1) +| Call: claim.claimant(claim14,V155) +| Exit: claim.claimant(claim14,person14) +| Call: person.occupation(person14,armed_forces) +| Fail: person.occupation(person14,armed_forces) +| Redo: claim.claimant(claim14,V155) +| Fail: claim.claimant(claim14,V155) +| Call: claim.reason(claim14,home_health_care) +| Fail: claim.reason(claim14,home_health_care) +| Call: claim.reason(claim14,home_health_care) +| Fail: claim.reason(claim14,home_health_care) +Fail: exception(claim14,policy1) +| | | Exit: ~exception(claim14,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim14) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Fail: contraceptive_location_check(iud_with_preogestin,contra_office) +| | | | Redo: claim.location(claim14,V154) +| | | | Fail: claim.location(claim14,V154) +| | | | Redo: fda_approved(iud_with_preogestin) +| | | | Fail: fda_approved(iud_with_preogestin) +| | | | Redo: claim.contraceptive_service(claim14,V153) +| | | | Fail: claim.contraceptive_service(claim14,V153) +| | | | Redo: claim.claimant(claim14,V152) +| | | | Fail: claim.claimant(claim14,V152) +| | | Fail: eligible_service(claim14,policy1,female_contraceptives) +| | | Redo: claim.reason(claim14,V130) +| | | Fail: claim.reason(claim14,V130) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim14,V129) +| | | Fail: claim.hospital(claim14,V129) +| | | Call: claim.reason(claim14,emergency_room) +| | | Fail: claim.reason(claim14,emergency_room) +| | Fail: valid_hospitalization(claim14,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V125) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V121) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V117) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V113) +| | | Redo: policy.enddate(policy1,person14,V112) +| | | Fail: policy.enddate(policy1,person14,V112) +| | | Redo: policy.startdate(policy1,person14,V111) +| | | Fail: policy.startdate(policy1,person14,V111) +| | | Redo: claim.hosp_end_time(claim14,V109,V110) +| | | Fail: claim.hosp_end_time(claim14,V109,V110) +| | | Redo: claim.hosp_start_time(claim14,V107,V108) +| | | Fail: claim.hosp_start_time(claim14,V107,V108) +| | | Redo: claim.claimant(claim14,V106) +| | | Fail: claim.claimant(claim14,V106) +| | Fail: policy_active(claim14,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person14) +| | | Fail: policy.insuree(policy1,person14) +| | | Redo: claim.claimant(claim14,V105) +| | | Fail: claim.claimant(claim14,V105) +| | Fail: valid_insuree(claim14,policy1) +| Fail: covered_under_policy(claim14,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Fail: policy.type(policy1,V2) +| Redo: claim.policy(X,V1) +| Exit: claim.policy(claim15,policy1) +| Call: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim15,policy1,cardinal) +| | Call: valid_insuree(claim15,policy1) +| | | Call: claim.claimant(claim15,V156) +| | | Exit: claim.claimant(claim15,person15) +| | | Call: policy.insuree(policy1,person15) +| | | Exit: policy.insuree(policy1,person15) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim15,policy1) +| | | Call: claim.claimant(claim15,V157) +| | | Exit: claim.claimant(claim15,person15) +| | | Call: claim.hosp_start_time(claim15,V158,V159) +| | | Exit: claim.hosp_start_time(claim15,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim15,V160,V161) +| | | Exit: claim.hosp_end_time(claim15,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person15,V162) +| | | Exit: policy.startdate(policy1,person15,01_08_2023) +| | | Call: policy.enddate(policy1,person15,V163) +| | | Exit: policy.enddate(policy1,person15,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V164) +| | | | Call: evaluate(parsedate(02_09_2023),[V165,V166,V167]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V164) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V168) +| | | | Call: evaluate(parsedate(02_09_2023),[V169,V170,V171]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V168) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V172) +| | | | Call: evaluate(parsedate(30_06_2024),[V173,V174,V175]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V172) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V176) +| | | | Call: evaluate(parsedate(01_08_2023),[V177,V178,V179]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V176) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim15,policy1) +| | | Call: claim.hospital(claim15,V180) +| | | Exit: claim.hospital(claim15,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim15,V181) +| | | Exit: claim.reason(claim15,female_contraceptives) +| | | Call: eligible_service(claim15,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim15,female_contraceptives) +| | | | | Call: claim.claimant(claim15,V182) +| | | | | Exit: claim.claimant(claim15,person15) +| | | | | Call: person.dob(person15,V183) +| | | | | Exit: person.dob(person15,01_01_2001) +| | | | | Call: claim.time(claim15,V184,V185) +| | | | | Exit: claim.time(claim15,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V186) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V187,V188,V189]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V190,V191,V192]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V193) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V194) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V195) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V196) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V186) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V197) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V198,V199,V197) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V198,V199,V197) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V197) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V186) +| | | | | Redo: claim.time(claim15,V184,V185) +| | | | | Fail: claim.time(claim15,V184,V185) +| | | | | Redo: person.dob(person15,V183) +| | | | | Fail: person.dob(person15,V183) +| | | | | Redo: claim.claimant(claim15,V182) +| | | | | Fail: claim.claimant(claim15,V182) +| | | | Fail: check_policy_year_limit(claim15,female_contraceptives) +| | | | Call: covered_list_with_location(V200) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V200) +| | | | Fail: covered_list_with_location(V200) +| | | | Call: covered_list_with_service_provider(V201) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V201) +| | | | Fail: covered_list_with_service_provider(V201) +| | | | Call: covered_list(V202) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V202) +| | | | Fail: covered_list(V202) +| | | | Call: claim.claimant(claim15,V203) +| | | | Exit: claim.claimant(claim15,person15) +| | | | Call: claim.contraceptive_service(claim15,V204) +| | | | Exit: claim.contraceptive_service(claim15,other) +| | | | Call: fda_approved(other) +| | | | Fail: fda_approved(other) +| | | | Redo: claim.contraceptive_service(claim15,V204) +| | | | Fail: claim.contraceptive_service(claim15,V204) +| | | | Redo: claim.claimant(claim15,V203) +| | | | Fail: claim.claimant(claim15,V203) +| | | Fail: eligible_service(claim15,policy1,female_contraceptives) +| | | Redo: claim.reason(claim15,V181) +| | | Fail: claim.reason(claim15,V181) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim15,V180) +| | | Fail: claim.hospital(claim15,V180) +| | | Call: claim.reason(claim15,emergency_room) +| | | Fail: claim.reason(claim15,emergency_room) +| | Fail: valid_hospitalization(claim15,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V176) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V172) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V168) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V164) +| | | Redo: policy.enddate(policy1,person15,V163) +| | | Fail: policy.enddate(policy1,person15,V163) +| | | Redo: policy.startdate(policy1,person15,V162) +| | | Fail: policy.startdate(policy1,person15,V162) +| | | Redo: claim.hosp_end_time(claim15,V160,V161) +| | | Fail: claim.hosp_end_time(claim15,V160,V161) +| | | Redo: claim.hosp_start_time(claim15,V158,V159) +| | | Fail: claim.hosp_start_time(claim15,V158,V159) +| | | Redo: claim.claimant(claim15,V157) +| | | Fail: claim.claimant(claim15,V157) +| | Fail: policy_active(claim15,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person15) +| | | Fail: policy.insuree(policy1,person15) +| | | Redo: claim.claimant(claim15,V156) +| | | Fail: claim.claimant(claim15,V156) +| | Fail: valid_insuree(claim15,policy1) +| Fail: covered_under_policy(claim15,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim15,policy1,cardinal) +| | Call: valid_insuree(claim15,policy1) +| | | Call: claim.claimant(claim15,V205) +| | | Exit: claim.claimant(claim15,person15) +| | | Call: policy.insuree(policy1,person15) +| | | Exit: policy.insuree(policy1,person15) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim15,policy1) +| | | Call: claim.claimant(claim15,V206) +| | | Exit: claim.claimant(claim15,person15) +| | | Call: claim.hosp_start_time(claim15,V207,V208) +| | | Exit: claim.hosp_start_time(claim15,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim15,V209,V210) +| | | Exit: claim.hosp_end_time(claim15,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person15,V211) +| | | Exit: policy.startdate(policy1,person15,01_08_2023) +| | | Call: policy.enddate(policy1,person15,V212) +| | | Exit: policy.enddate(policy1,person15,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V213) +| | | | Call: evaluate(parsedate(02_09_2023),[V214,V215,V216]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V213) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V217) +| | | | Call: evaluate(parsedate(02_09_2023),[V218,V219,V220]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V217) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V221) +| | | | Call: evaluate(parsedate(30_06_2024),[V222,V223,V224]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V221) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V225) +| | | | Call: evaluate(parsedate(01_08_2023),[V226,V227,V228]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V225) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim15,policy1) +| | | Call: claim.hospital(claim15,V229) +| | | Exit: claim.hospital(claim15,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim15,V230) +| | | Exit: claim.reason(claim15,female_contraceptives) +| | | Call: eligible_service(claim15,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim15,female_contraceptives) +| | | | | Call: claim.claimant(claim15,V231) +| | | | | Exit: claim.claimant(claim15,person15) +| | | | | Call: person.dob(person15,V232) +| | | | | Exit: person.dob(person15,01_01_2001) +| | | | | Call: claim.time(claim15,V233,V234) +| | | | | Exit: claim.time(claim15,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V235) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V236,V237,V238]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V239,V240,V241]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V242) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V243) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V244) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V245) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V235) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V246) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V247,V248,V246) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V247,V248,V246) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V246) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V235) +| | | | | Redo: claim.time(claim15,V233,V234) +| | | | | Fail: claim.time(claim15,V233,V234) +| | | | | Redo: person.dob(person15,V232) +| | | | | Fail: person.dob(person15,V232) +| | | | | Redo: claim.claimant(claim15,V231) +| | | | | Fail: claim.claimant(claim15,V231) +| | | | Fail: check_policy_year_limit(claim15,female_contraceptives) +| | | | Call: covered_list_with_location(V249) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V249) +| | | | Fail: covered_list_with_location(V249) +| | | | Call: covered_list_with_service_provider(V250) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V250) +| | | | Fail: covered_list_with_service_provider(V250) +| | | | Call: covered_list(V251) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V251) +| | | | Fail: covered_list(V251) +| | | | Call: claim.claimant(claim15,V252) +| | | | Exit: claim.claimant(claim15,person15) +| | | | Call: claim.contraceptive_service(claim15,V253) +| | | | Exit: claim.contraceptive_service(claim15,other) +| | | | Call: fda_approved(other) +| | | | Fail: fda_approved(other) +| | | | Redo: claim.contraceptive_service(claim15,V253) +| | | | Fail: claim.contraceptive_service(claim15,V253) +| | | | Redo: claim.claimant(claim15,V252) +| | | | Fail: claim.claimant(claim15,V252) +| | | Fail: eligible_service(claim15,policy1,female_contraceptives) +| | | Redo: claim.reason(claim15,V230) +| | | Fail: claim.reason(claim15,V230) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim15,V229) +| | | Fail: claim.hospital(claim15,V229) +| | | Call: claim.reason(claim15,emergency_room) +| | | Fail: claim.reason(claim15,emergency_room) +| | Fail: valid_hospitalization(claim15,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V225) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V221) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V217) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V213) +| | | Redo: policy.enddate(policy1,person15,V212) +| | | Fail: policy.enddate(policy1,person15,V212) +| | | Redo: policy.startdate(policy1,person15,V211) +| | | Fail: policy.startdate(policy1,person15,V211) +| | | Redo: claim.hosp_end_time(claim15,V209,V210) +| | | Fail: claim.hosp_end_time(claim15,V209,V210) +| | | Redo: claim.hosp_start_time(claim15,V207,V208) +| | | Fail: claim.hosp_start_time(claim15,V207,V208) +| | | Redo: claim.claimant(claim15,V206) +| | | Fail: claim.claimant(claim15,V206) +| | Fail: policy_active(claim15,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person15) +| | | Fail: policy.insuree(policy1,person15) +| | | Redo: claim.claimant(claim15,V205) +| | | Fail: claim.claimant(claim15,V205) +| | Fail: valid_insuree(claim15,policy1) +| Fail: covered_under_policy(claim15,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim15,policy1,cardinal) +| | Call: valid_insuree(claim15,policy1) +| | | Call: claim.claimant(claim15,V254) +| | | Exit: claim.claimant(claim15,person15) +| | | Call: policy.insuree(policy1,person15) +| | | Exit: policy.insuree(policy1,person15) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim15,policy1) +| | | Call: claim.claimant(claim15,V255) +| | | Exit: claim.claimant(claim15,person15) +| | | Call: claim.hosp_start_time(claim15,V256,V257) +| | | Exit: claim.hosp_start_time(claim15,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim15,V258,V259) +| | | Exit: claim.hosp_end_time(claim15,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person15,V260) +| | | Exit: policy.startdate(policy1,person15,01_08_2023) +| | | Call: policy.enddate(policy1,person15,V261) +| | | Exit: policy.enddate(policy1,person15,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V262) +| | | | Call: evaluate(parsedate(02_09_2023),[V263,V264,V265]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V262) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V266) +| | | | Call: evaluate(parsedate(02_09_2023),[V267,V268,V269]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V266) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V270) +| | | | Call: evaluate(parsedate(30_06_2024),[V271,V272,V273]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V270) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V274) +| | | | Call: evaluate(parsedate(01_08_2023),[V275,V276,V277]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V274) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim15,policy1) +| | | Call: claim.hospital(claim15,V278) +| | | Exit: claim.hospital(claim15,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim15,V279) +| | | Exit: claim.reason(claim15,female_contraceptives) +| | | Call: eligible_service(claim15,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim15,female_contraceptives) +| | | | | Call: claim.claimant(claim15,V280) +| | | | | Exit: claim.claimant(claim15,person15) +| | | | | Call: person.dob(person15,V281) +| | | | | Exit: person.dob(person15,01_01_2001) +| | | | | Call: claim.time(claim15,V282,V283) +| | | | | Exit: claim.time(claim15,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V284) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V285,V286,V287]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V288,V289,V290]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V291) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V292) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V293) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V294) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V284) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V295) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V296,V297,V295) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V296,V297,V295) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V295) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V284) +| | | | | Redo: claim.time(claim15,V282,V283) +| | | | | Fail: claim.time(claim15,V282,V283) +| | | | | Redo: person.dob(person15,V281) +| | | | | Fail: person.dob(person15,V281) +| | | | | Redo: claim.claimant(claim15,V280) +| | | | | Fail: claim.claimant(claim15,V280) +| | | | Fail: check_policy_year_limit(claim15,female_contraceptives) +| | | | Call: covered_list_with_location(V298) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V298) +| | | | Fail: covered_list_with_location(V298) +| | | | Call: covered_list_with_service_provider(V299) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V299) +| | | | Fail: covered_list_with_service_provider(V299) +| | | | Call: covered_list(V300) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V300) +| | | | Fail: covered_list(V300) +| | | | Call: claim.claimant(claim15,V301) +| | | | Exit: claim.claimant(claim15,person15) +| | | | Call: claim.contraceptive_service(claim15,V302) +| | | | Exit: claim.contraceptive_service(claim15,other) +| | | | Call: fda_approved(other) +| | | | Fail: fda_approved(other) +| | | | Redo: claim.contraceptive_service(claim15,V302) +| | | | Fail: claim.contraceptive_service(claim15,V302) +| | | | Redo: claim.claimant(claim15,V301) +| | | | Fail: claim.claimant(claim15,V301) +| | | Fail: eligible_service(claim15,policy1,female_contraceptives) +| | | Redo: claim.reason(claim15,V279) +| | | Fail: claim.reason(claim15,V279) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim15,V278) +| | | Fail: claim.hospital(claim15,V278) +| | | Call: claim.reason(claim15,emergency_room) +| | | Fail: claim.reason(claim15,emergency_room) +| | Fail: valid_hospitalization(claim15,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V274) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V270) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V266) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V262) +| | | Redo: policy.enddate(policy1,person15,V261) +| | | Fail: policy.enddate(policy1,person15,V261) +| | | Redo: policy.startdate(policy1,person15,V260) +| | | Fail: policy.startdate(policy1,person15,V260) +| | | Redo: claim.hosp_end_time(claim15,V258,V259) +| | | Fail: claim.hosp_end_time(claim15,V258,V259) +| | | Redo: claim.hosp_start_time(claim15,V256,V257) +| | | Fail: claim.hosp_start_time(claim15,V256,V257) +| | | Redo: claim.claimant(claim15,V255) +| | | Fail: claim.claimant(claim15,V255) +| | Fail: policy_active(claim15,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person15) +| | | Fail: policy.insuree(policy1,person15) +| | | Redo: claim.claimant(claim15,V254) +| | | Fail: claim.claimant(claim15,V254) +| | Fail: valid_insuree(claim15,policy1) +| Fail: covered_under_policy(claim15,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Fail: policy.type(policy1,V2) +| Redo: claim.policy(X,V1) +| Exit: claim.policy(claim16,policy1) +| Call: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim16,policy1,cardinal) +| | Call: valid_insuree(claim16,policy1) +| | | Call: claim.claimant(claim16,V303) +| | | Exit: claim.claimant(claim16,person16) +| | | Call: policy.insuree(policy1,person16) +| | | Exit: policy.insuree(policy1,person16) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim16,policy1) +| | | Call: claim.claimant(claim16,V304) +| | | Exit: claim.claimant(claim16,person16) +| | | Call: claim.hosp_start_time(claim16,V305,V306) +| | | Exit: claim.hosp_start_time(claim16,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim16,V307,V308) +| | | Exit: claim.hosp_end_time(claim16,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person16,V309) +| | | Exit: policy.startdate(policy1,person16,01_08_2023) +| | | Call: policy.enddate(policy1,person16,V310) +| | | Exit: policy.enddate(policy1,person16,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V311) +| | | | Call: evaluate(parsedate(02_09_2023),[V312,V313,V314]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V311) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V315) +| | | | Call: evaluate(parsedate(02_09_2023),[V316,V317,V318]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V315) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V319) +| | | | Call: evaluate(parsedate(30_06_2024),[V320,V321,V322]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V319) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V323) +| | | | Call: evaluate(parsedate(01_08_2023),[V324,V325,V326]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V323) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim16,policy1) +| | | Call: claim.hospital(claim16,V327) +| | | Exit: claim.hospital(claim16,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim16,V328) +| | | Exit: claim.reason(claim16,female_contraceptives) +| | | Call: eligible_service(claim16,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim16,female_contraceptives) +| | | | | Call: claim.claimant(claim16,V329) +| | | | | Exit: claim.claimant(claim16,person16) +| | | | | Call: person.dob(person16,V330) +| | | | | Exit: person.dob(person16,01_01_2001) +| | | | | Call: claim.time(claim16,V331,V332) +| | | | | Exit: claim.time(claim16,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V333) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V334,V335,V336]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V337,V338,V339]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V340) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V341) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V342) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V343) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V333) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V344) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V345,V346,V344) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V345,V346,V344) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V344) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V333) +| | | | | Redo: claim.time(claim16,V331,V332) +| | | | | Fail: claim.time(claim16,V331,V332) +| | | | | Redo: person.dob(person16,V330) +| | | | | Fail: person.dob(person16,V330) +| | | | | Redo: claim.claimant(claim16,V329) +| | | | | Fail: claim.claimant(claim16,V329) +| | | | Fail: check_policy_year_limit(claim16,female_contraceptives) +| | | | Call: covered_list_with_location(V347) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V347) +| | | | Fail: covered_list_with_location(V347) +| | | | Call: covered_list_with_service_provider(V348) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V348) +| | | | Fail: covered_list_with_service_provider(V348) +| | | | Call: covered_list(V349) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V349) +| | | | Fail: covered_list(V349) +| | | | Call: claim.claimant(claim16,V350) +| | | | Exit: claim.claimant(claim16,person16) +| | | | Call: claim.contraceptive_service(claim16,V351) +| | | | Exit: claim.contraceptive_service(claim16,iud_with_preogestin) +| | | | Call: fda_approved(iud_with_preogestin) +| | | | Exit: fda_approved(iud_with_preogestin) +| | | | Call: claim.location(claim16,V352) +| | | | Exit: claim.location(claim16,hospital) +| | | | Call: contraceptive_location_check(iud_with_preogestin,hospital) +| | | | Fail: contraceptive_location_check(iud_with_preogestin,hospital) +| | | | Redo: claim.location(claim16,V352) +| | | | Fail: claim.location(claim16,V352) +| | | | Redo: fda_approved(iud_with_preogestin) +| | | | Fail: fda_approved(iud_with_preogestin) +| | | | Redo: claim.contraceptive_service(claim16,V351) +| | | | Fail: claim.contraceptive_service(claim16,V351) +| | | | Redo: claim.claimant(claim16,V350) +| | | | Fail: claim.claimant(claim16,V350) +| | | Fail: eligible_service(claim16,policy1,female_contraceptives) +| | | Redo: claim.reason(claim16,V328) +| | | Fail: claim.reason(claim16,V328) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim16,V327) +| | | Fail: claim.hospital(claim16,V327) +| | | Call: claim.reason(claim16,emergency_room) +| | | Fail: claim.reason(claim16,emergency_room) +| | Fail: valid_hospitalization(claim16,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V323) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V319) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V315) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V311) +| | | Redo: policy.enddate(policy1,person16,V310) +| | | Fail: policy.enddate(policy1,person16,V310) +| | | Redo: policy.startdate(policy1,person16,V309) +| | | Fail: policy.startdate(policy1,person16,V309) +| | | Redo: claim.hosp_end_time(claim16,V307,V308) +| | | Fail: claim.hosp_end_time(claim16,V307,V308) +| | | Redo: claim.hosp_start_time(claim16,V305,V306) +| | | Fail: claim.hosp_start_time(claim16,V305,V306) +| | | Redo: claim.claimant(claim16,V304) +| | | Fail: claim.claimant(claim16,V304) +| | Fail: policy_active(claim16,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person16) +| | | Fail: policy.insuree(policy1,person16) +| | | Redo: claim.claimant(claim16,V303) +| | | Fail: claim.claimant(claim16,V303) +| | Fail: valid_insuree(claim16,policy1) +| Fail: covered_under_policy(claim16,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim16,policy1,cardinal) +| | Call: valid_insuree(claim16,policy1) +| | | Call: claim.claimant(claim16,V353) +| | | Exit: claim.claimant(claim16,person16) +| | | Call: policy.insuree(policy1,person16) +| | | Exit: policy.insuree(policy1,person16) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim16,policy1) +| | | Call: claim.claimant(claim16,V354) +| | | Exit: claim.claimant(claim16,person16) +| | | Call: claim.hosp_start_time(claim16,V355,V356) +| | | Exit: claim.hosp_start_time(claim16,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim16,V357,V358) +| | | Exit: claim.hosp_end_time(claim16,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person16,V359) +| | | Exit: policy.startdate(policy1,person16,01_08_2023) +| | | Call: policy.enddate(policy1,person16,V360) +| | | Exit: policy.enddate(policy1,person16,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V361) +| | | | Call: evaluate(parsedate(02_09_2023),[V362,V363,V364]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V361) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V365) +| | | | Call: evaluate(parsedate(02_09_2023),[V366,V367,V368]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V365) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V369) +| | | | Call: evaluate(parsedate(30_06_2024),[V370,V371,V372]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V369) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V373) +| | | | Call: evaluate(parsedate(01_08_2023),[V374,V375,V376]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V373) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim16,policy1) +| | | Call: claim.hospital(claim16,V377) +| | | Exit: claim.hospital(claim16,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim16,V378) +| | | Exit: claim.reason(claim16,female_contraceptives) +| | | Call: eligible_service(claim16,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim16,female_contraceptives) +| | | | | Call: claim.claimant(claim16,V379) +| | | | | Exit: claim.claimant(claim16,person16) +| | | | | Call: person.dob(person16,V380) +| | | | | Exit: person.dob(person16,01_01_2001) +| | | | | Call: claim.time(claim16,V381,V382) +| | | | | Exit: claim.time(claim16,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V383) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V384,V385,V386]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V387,V388,V389]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V390) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V391) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V392) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V393) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V383) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V394) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V395,V396,V394) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V395,V396,V394) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V394) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V383) +| | | | | Redo: claim.time(claim16,V381,V382) +| | | | | Fail: claim.time(claim16,V381,V382) +| | | | | Redo: person.dob(person16,V380) +| | | | | Fail: person.dob(person16,V380) +| | | | | Redo: claim.claimant(claim16,V379) +| | | | | Fail: claim.claimant(claim16,V379) +| | | | Fail: check_policy_year_limit(claim16,female_contraceptives) +| | | | Call: covered_list_with_location(V397) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V397) +| | | | Fail: covered_list_with_location(V397) +| | | | Call: covered_list_with_service_provider(V398) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V398) +| | | | Fail: covered_list_with_service_provider(V398) +| | | | Call: covered_list(V399) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V399) +| | | | Fail: covered_list(V399) +| | | | Call: claim.claimant(claim16,V400) +| | | | Exit: claim.claimant(claim16,person16) +| | | | Call: claim.contraceptive_service(claim16,V401) +| | | | Exit: claim.contraceptive_service(claim16,iud_with_preogestin) +| | | | Call: fda_approved(iud_with_preogestin) +| | | | Exit: fda_approved(iud_with_preogestin) +| | | | Call: claim.location(claim16,V402) +| | | | Exit: claim.location(claim16,hospital) +| | | | Call: contraceptive_location_check(iud_with_preogestin,hospital) +| | | | Fail: contraceptive_location_check(iud_with_preogestin,hospital) +| | | | Redo: claim.location(claim16,V402) +| | | | Fail: claim.location(claim16,V402) +| | | | Redo: fda_approved(iud_with_preogestin) +| | | | Fail: fda_approved(iud_with_preogestin) +| | | | Redo: claim.contraceptive_service(claim16,V401) +| | | | Fail: claim.contraceptive_service(claim16,V401) +| | | | Redo: claim.claimant(claim16,V400) +| | | | Fail: claim.claimant(claim16,V400) +| | | Fail: eligible_service(claim16,policy1,female_contraceptives) +| | | Redo: claim.reason(claim16,V378) +| | | Fail: claim.reason(claim16,V378) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim16,V377) +| | | Fail: claim.hospital(claim16,V377) +| | | Call: claim.reason(claim16,emergency_room) +| | | Fail: claim.reason(claim16,emergency_room) +| | Fail: valid_hospitalization(claim16,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V373) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V369) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V365) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V361) +| | | Redo: policy.enddate(policy1,person16,V360) +| | | Fail: policy.enddate(policy1,person16,V360) +| | | Redo: policy.startdate(policy1,person16,V359) +| | | Fail: policy.startdate(policy1,person16,V359) +| | | Redo: claim.hosp_end_time(claim16,V357,V358) +| | | Fail: claim.hosp_end_time(claim16,V357,V358) +| | | Redo: claim.hosp_start_time(claim16,V355,V356) +| | | Fail: claim.hosp_start_time(claim16,V355,V356) +| | | Redo: claim.claimant(claim16,V354) +| | | Fail: claim.claimant(claim16,V354) +| | Fail: policy_active(claim16,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person16) +| | | Fail: policy.insuree(policy1,person16) +| | | Redo: claim.claimant(claim16,V353) +| | | Fail: claim.claimant(claim16,V353) +| | Fail: valid_insuree(claim16,policy1) +| Fail: covered_under_policy(claim16,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim16,policy1,cardinal) +| | Call: valid_insuree(claim16,policy1) +| | | Call: claim.claimant(claim16,V403) +| | | Exit: claim.claimant(claim16,person16) +| | | Call: policy.insuree(policy1,person16) +| | | Exit: policy.insuree(policy1,person16) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim16,policy1) +| | | Call: claim.claimant(claim16,V404) +| | | Exit: claim.claimant(claim16,person16) +| | | Call: claim.hosp_start_time(claim16,V405,V406) +| | | Exit: claim.hosp_start_time(claim16,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim16,V407,V408) +| | | Exit: claim.hosp_end_time(claim16,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person16,V409) +| | | Exit: policy.startdate(policy1,person16,01_08_2023) +| | | Call: policy.enddate(policy1,person16,V410) +| | | Exit: policy.enddate(policy1,person16,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V411) +| | | | Call: evaluate(parsedate(02_09_2023),[V412,V413,V414]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V411) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V415) +| | | | Call: evaluate(parsedate(02_09_2023),[V416,V417,V418]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V415) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V419) +| | | | Call: evaluate(parsedate(30_06_2024),[V420,V421,V422]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V419) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V423) +| | | | Call: evaluate(parsedate(01_08_2023),[V424,V425,V426]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V423) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim16,policy1) +| | | Call: claim.hospital(claim16,V427) +| | | Exit: claim.hospital(claim16,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim16,V428) +| | | Exit: claim.reason(claim16,female_contraceptives) +| | | Call: eligible_service(claim16,policy1,female_contraceptives) +| | | | Call: check_policy_year_limit(claim16,female_contraceptives) +| | | | | Call: claim.claimant(claim16,V429) +| | | | | Exit: claim.claimant(claim16,person16) +| | | | | Call: person.dob(person16,V430) +| | | | | Exit: person.dob(person16,01_01_2001) +| | | | | Call: claim.time(claim16,V431,V432) +| | | | | Exit: claim.time(claim16,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V433) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V434,V435,V436]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V437,V438,V439]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V440) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V441) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V442) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V443) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V433) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(female_contraceptives,23,V444) +| | | | | | Call: yearly_visit_limit(female_contraceptives,V445,V446,V444) +| | | | | | Fail: yearly_visit_limit(female_contraceptives,V445,V446,V444) +| | | | | Fail: yearly_visit_limit(female_contraceptives,23,V444) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V433) +| | | | | Redo: claim.time(claim16,V431,V432) +| | | | | Fail: claim.time(claim16,V431,V432) +| | | | | Redo: person.dob(person16,V430) +| | | | | Fail: person.dob(person16,V430) +| | | | | Redo: claim.claimant(claim16,V429) +| | | | | Fail: claim.claimant(claim16,V429) +| | | | Fail: check_policy_year_limit(claim16,female_contraceptives) +| | | | Call: covered_list_with_location(V447) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(female_contraceptives,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V447) +| | | | Fail: covered_list_with_location(V447) +| | | | Call: covered_list_with_service_provider(V448) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(female_contraceptives,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V448) +| | | | Fail: covered_list_with_service_provider(V448) +| | | | Call: covered_list(V449) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(female_contraceptives,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V449) +| | | | Fail: covered_list(V449) +| | | | Call: claim.claimant(claim16,V450) +| | | | Exit: claim.claimant(claim16,person16) +| | | | Call: claim.contraceptive_service(claim16,V451) +| | | | Exit: claim.contraceptive_service(claim16,iud_with_preogestin) +| | | | Call: fda_approved(iud_with_preogestin) +| | | | Exit: fda_approved(iud_with_preogestin) +| | | | Call: claim.location(claim16,V452) +| | | | Exit: claim.location(claim16,hospital) +| | | | Call: contraceptive_location_check(iud_with_preogestin,hospital) +| | | | Fail: contraceptive_location_check(iud_with_preogestin,hospital) +| | | | Redo: claim.location(claim16,V452) +| | | | Fail: claim.location(claim16,V452) +| | | | Redo: fda_approved(iud_with_preogestin) +| | | | Fail: fda_approved(iud_with_preogestin) +| | | | Redo: claim.contraceptive_service(claim16,V451) +| | | | Fail: claim.contraceptive_service(claim16,V451) +| | | | Redo: claim.claimant(claim16,V450) +| | | | Fail: claim.claimant(claim16,V450) +| | | Fail: eligible_service(claim16,policy1,female_contraceptives) +| | | Redo: claim.reason(claim16,V428) +| | | Fail: claim.reason(claim16,V428) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim16,V427) +| | | Fail: claim.hospital(claim16,V427) +| | | Call: claim.reason(claim16,emergency_room) +| | | Fail: claim.reason(claim16,emergency_room) +| | Fail: valid_hospitalization(claim16,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V423) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V419) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V415) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V411) +| | | Redo: policy.enddate(policy1,person16,V410) +| | | Fail: policy.enddate(policy1,person16,V410) +| | | Redo: policy.startdate(policy1,person16,V409) +| | | Fail: policy.startdate(policy1,person16,V409) +| | | Redo: claim.hosp_end_time(claim16,V407,V408) +| | | Fail: claim.hosp_end_time(claim16,V407,V408) +| | | Redo: claim.hosp_start_time(claim16,V405,V406) +| | | Fail: claim.hosp_start_time(claim16,V405,V406) +| | | Redo: claim.claimant(claim16,V404) +| | | Fail: claim.claimant(claim16,V404) +| | Fail: policy_active(claim16,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person16) +| | | Fail: policy.insuree(policy1,person16) +| | | Redo: claim.claimant(claim16,V403) +| | | Fail: claim.claimant(claim16,V403) +| | Fail: valid_insuree(claim16,policy1) +| Fail: covered_under_policy(claim16,policy1,cardinal) +| Redo: policy.type(policy1,V2) +| Fail: policy.type(policy1,V2) +| Redo: claim.policy(X,V1) +| Fail: claim.policy(X,V1) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_contraceptives.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim14' ] +RESULTS: [ 'claim14' ] +===== TEST SUCCEEDED: Test test_cases_contraceptives.hdf===== +Expected Result: [ 'claim_a9', 'claim_a11' ] +Call: covered(X) +| Call: claim.policy(X,V453) +| Exit: claim.policy(claim_a9,policy1) +| Call: policy.type(policy1,V454) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a9,policy1,cardinal) +| | Call: valid_insuree(claim_a9,policy1) +| | | Call: claim.claimant(claim_a9,V455) +| | | Exit: claim.claimant(claim_a9,person_a9) +| | | Call: policy.insuree(policy1,person_a9) +| | | Exit: policy.insuree(policy1,person_a9) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a9,policy1) +| | | Call: claim.claimant(claim_a9,V456) +| | | Exit: claim.claimant(claim_a9,person_a9) +| | | Call: claim.hosp_start_time(claim_a9,V457,V458) +| | | Exit: claim.hosp_start_time(claim_a9,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a9,V459,V460) +| | | Exit: claim.hosp_end_time(claim_a9,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a9,V461) +| | | Exit: policy.startdate(policy1,person_a9,01_08_2023) +| | | Call: policy.enddate(policy1,person_a9,V462) +| | | Exit: policy.enddate(policy1,person_a9,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V463) +| | | | Call: evaluate(parsedate(03_09_2023),[V464,V465,V466]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V463) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V467) +| | | | Call: evaluate(parsedate(03_09_2023),[V468,V469,V470]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V467) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V471) +| | | | Call: evaluate(parsedate(30_06_2024),[V472,V473,V474]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V471) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V475) +| | | | Call: evaluate(parsedate(01_08_2023),[V476,V477,V478]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V475) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a9,policy1) +| | | Call: claim.hospital(claim_a9,V479) +| | | Exit: claim.hospital(claim_a9,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a9,V480) +| | | Exit: claim.reason(claim_a9,preventive_care) +| | | Call: eligible_service(claim_a9,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a9,preventive_care) +| | | | | Call: claim.claimant(claim_a9,V481) +| | | | | Exit: claim.claimant(claim_a9,person_a9) +| | | | | Call: person.dob(person_a9,V482) +| | | | | Exit: person.dob(person_a9,04_02_2023) +| | | | | Call: claim.time(claim_a9,V483,V484) +| | | | | Fail: claim.time(claim_a9,V483,V484) +| | | | | Redo: person.dob(person_a9,V482) +| | | | | Fail: person.dob(person_a9,V482) +| | | | | Redo: claim.claimant(claim_a9,V481) +| | | | | Fail: claim.claimant(claim_a9,V481) +| | | | Fail: check_policy_year_limit(claim_a9,preventive_care) +| | | | Call: covered_list_with_location(V485) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V485) +| | | | Fail: covered_list_with_location(V485) +| | | | Call: covered_list_with_service_provider(V486) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V486) +| | | | Fail: covered_list_with_service_provider(V486) +| | | | Call: covered_list(V487) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V487) +| | | | Fail: covered_list(V487) +| | | | Call: claim.location(claim_a9,V488) +| | | | Exit: claim.location(claim_a9,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a9,hep_b) +| | | | Fail: claim.vaccine(claim_a9,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a9,V488) +| | | | Fail: claim.location(claim_a9,V488) +| | | | Call: claim.location(claim_a9,V489) +| | | | Exit: claim.location(claim_a9,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a9,covid) +| | | | Exit: claim.vaccine(claim_a9,covid) +| | | | Call: claim.claimant(claim_a9,V490) +| | | | Exit: claim.claimant(claim_a9,person_a9) +| | | | Call: person.dob(person_a9,V491) +| | | | Exit: person.dob(person_a9,04_02_2023) +| | | | Call: claim.hosp_start_time(claim_a9,V492,V493) +| | | | Exit: claim.hosp_start_time(claim_a9,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_02_2023,V494) +| | | | | Call: evaluate(parsedate(03_09_2023),[V495,V496,V497]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V498,V499,V500]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V501) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V502) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V503) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,7),-1),V504) +| | | | | Exit: evaluate(plus(imul(31,7),-1),216) +| | | | | Call: evaluate(plus(0,if(leq(216,-1),-1,true,0)),V494) +| | | | | Exit: evaluate(plus(0,if(leq(216,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2023,V505) +| | | | | Call: evaluate(parsedate(03_09_2023),[V506,V507,V508]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V509,V510,V511]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V512) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V513) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V514) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),7),V515) +| | | | | Exit: evaluate(plus(imul(12,0),7),7) +| | | | | Call: evaluate(if(leq(-1,-1),minus(7,1),true,7),V505) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(7,1),true,7),6) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: person.immunocompromised(person_a9,V516) +| | | | Exit: person.immunocompromised(person_a9,no) +| | | | Call: claim.vaccine_brand(claim_a9,V517) +| | | | Exit: claim.vaccine_brand(claim_a9,moderna) +| | | | Call: claim.previous_vaccines_pfizer(claim_a9,V518) +| | | | Exit: claim.previous_vaccines_pfizer(claim_a9,0) +| | | | Call: claim.previous_vaccines_moderna(claim_a9,V519) +| | | | Exit: claim.previous_vaccines_moderna(claim_a9,0) +| | | | Call: claim.previous_vaccines_other(claim_a9,V520) +| | | | Exit: claim.previous_vaccines_other(claim_a9,0) +| | | | Call: age_range_limit_covid(claim_a9,V521,0,6,no,moderna,0,0,0) +| | | | | Call: leq(0,4) +| | | | | Exit: leq(0,4) +| | | | | Call: leq(6,6) +| | | | | Exit: leq(6,6) +| | | | Exit: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | Call: claim.vaccine_dose_count(claim_a9,V522) +| | | | Exit: claim.vaccine_dose_count(claim_a9,2) +| | | | Call: leq(2,2) +| | | | Exit: leq(2,2) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a9,policy1) +Call: exception(claim_a9,policy1) +| Call: claim.claimant(claim_a9,V523) +| Exit: claim.claimant(claim_a9,person_a9) +| Call: person.occupation(person_a9,armed_forces) +| Fail: person.occupation(person_a9,armed_forces) +| Redo: claim.claimant(claim_a9,V523) +| Fail: claim.claimant(claim_a9,V523) +| Call: claim.reason(claim_a9,home_health_care) +| Fail: claim.reason(claim_a9,home_health_care) +| Call: claim.reason(claim_a9,home_health_care) +| Fail: claim.reason(claim_a9,home_health_care) +Fail: exception(claim_a9,policy1) +| | | Exit: ~exception(claim_a9,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a9) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: claim.vaccine_dose_count(claim_a9,V522) +| | | | Fail: claim.vaccine_dose_count(claim_a9,V522) +| | | | Redo: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | | Call: leq(0,4) +| | | | | Exit: leq(0,4) +| | | | | Call: leq(6,6) +| | | | | Exit: leq(6,6) +| | | | | Call: leq(1,0) +| | | | | Fail: leq(1,0) +| | | | | Call: leq(5,0) +| | | | | Fail: leq(5,0) +| | | | | Call: evaluate(plus(0,0,0),V524) +| | | | | Exit: evaluate(plus(0,0,0),0) +| | | | | Call: leq(5,0) +| | | | | Fail: leq(5,0) +| | | | Fail: age_range_limit_covid(claim_a9,V521,0,6,no,moderna,0,0,0) +| | | | Redo: claim.previous_vaccines_other(claim_a9,V520) +| | | | Fail: claim.previous_vaccines_other(claim_a9,V520) +| | | | Redo: claim.previous_vaccines_moderna(claim_a9,V519) +| | | | Fail: claim.previous_vaccines_moderna(claim_a9,V519) +| | | | Redo: claim.previous_vaccines_pfizer(claim_a9,V518) +| | | | Fail: claim.previous_vaccines_pfizer(claim_a9,V518) +| | | | Redo: claim.vaccine_brand(claim_a9,V517) +| | | | Fail: claim.vaccine_brand(claim_a9,V517) +| | | | Redo: person.immunocompromised(person_a9,V516) +| | | | Fail: person.immunocompromised(person_a9,V516) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2023,V505) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_02_2023,V494) +| | | | Redo: claim.hosp_start_time(claim_a9,V492,V493) +| | | | Fail: claim.hosp_start_time(claim_a9,V492,V493) +| | | | Redo: person.dob(person_a9,V491) +| | | | Fail: person.dob(person_a9,V491) +| | | | Redo: claim.claimant(claim_a9,V490) +| | | | Fail: claim.claimant(claim_a9,V490) +| | | | Redo: claim.vaccine(claim_a9,covid) +| | | | Fail: claim.vaccine(claim_a9,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a9,V489) +| | | | Fail: claim.location(claim_a9,V489) +| | | | Call: claim.location(claim_a9,V525) +| | | | Exit: claim.location(claim_a9,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a9,flu) +| | | | Fail: claim.vaccine(claim_a9,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a9,V525) +| | | | Fail: claim.location(claim_a9,V525) +| | | Fail: eligible_service(claim_a9,policy1,preventive_care) +| | | Redo: claim.reason(claim_a9,V480) +| | | Fail: claim.reason(claim_a9,V480) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a9,V479) +| | | Fail: claim.hospital(claim_a9,V479) +| | | Call: claim.reason(claim_a9,emergency_room) +| | | Fail: claim.reason(claim_a9,emergency_room) +| | Fail: valid_hospitalization(claim_a9,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V475) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V471) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V467) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V463) +| | | Redo: policy.enddate(policy1,person_a9,V462) +| | | Fail: policy.enddate(policy1,person_a9,V462) +| | | Redo: policy.startdate(policy1,person_a9,V461) +| | | Fail: policy.startdate(policy1,person_a9,V461) +| | | Redo: claim.hosp_end_time(claim_a9,V459,V460) +| | | Fail: claim.hosp_end_time(claim_a9,V459,V460) +| | | Redo: claim.hosp_start_time(claim_a9,V457,V458) +| | | Fail: claim.hosp_start_time(claim_a9,V457,V458) +| | | Redo: claim.claimant(claim_a9,V456) +| | | Fail: claim.claimant(claim_a9,V456) +| | Fail: policy_active(claim_a9,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a9) +| | | Fail: policy.insuree(policy1,person_a9) +| | | Redo: claim.claimant(claim_a9,V455) +| | | Fail: claim.claimant(claim_a9,V455) +| | Fail: valid_insuree(claim_a9,policy1) +| Fail: covered_under_policy(claim_a9,policy1,cardinal) +| Redo: policy.type(policy1,V454) +| Fail: policy.type(policy1,V454) +| Redo: claim.policy(X,V453) +| Exit: claim.policy(claim_a10,policy1) +| Call: policy.type(policy1,V454) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a10,policy1,cardinal) +| | Call: valid_insuree(claim_a10,policy1) +| | | Call: claim.claimant(claim_a10,V526) +| | | Exit: claim.claimant(claim_a10,person_a10) +| | | Call: policy.insuree(policy1,person_a10) +| | | Exit: policy.insuree(policy1,person_a10) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a10,policy1) +| | | Call: claim.claimant(claim_a10,V527) +| | | Exit: claim.claimant(claim_a10,person_a10) +| | | Call: claim.hosp_start_time(claim_a10,V528,V529) +| | | Exit: claim.hosp_start_time(claim_a10,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a10,V530,V531) +| | | Exit: claim.hosp_end_time(claim_a10,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a10,V532) +| | | Exit: policy.startdate(policy1,person_a10,01_08_2023) +| | | Call: policy.enddate(policy1,person_a10,V533) +| | | Exit: policy.enddate(policy1,person_a10,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V534) +| | | | Call: evaluate(parsedate(03_09_2023),[V535,V536,V537]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V534) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V538) +| | | | Call: evaluate(parsedate(03_09_2023),[V539,V540,V541]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V538) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V542) +| | | | Call: evaluate(parsedate(30_06_2024),[V543,V544,V545]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V542) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V546) +| | | | Call: evaluate(parsedate(01_08_2023),[V547,V548,V549]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V546) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a10,policy1) +| | | Call: claim.hospital(claim_a10,V550) +| | | Exit: claim.hospital(claim_a10,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a10,V551) +| | | Exit: claim.reason(claim_a10,preventive_care) +| | | Call: eligible_service(claim_a10,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a10,preventive_care) +| | | | | Call: claim.claimant(claim_a10,V552) +| | | | | Exit: claim.claimant(claim_a10,person_a10) +| | | | | Call: person.dob(person_a10,V553) +| | | | | Exit: person.dob(person_a10,04_02_2023) +| | | | | Call: claim.time(claim_a10,V554,V555) +| | | | | Fail: claim.time(claim_a10,V554,V555) +| | | | | Redo: person.dob(person_a10,V553) +| | | | | Fail: person.dob(person_a10,V553) +| | | | | Redo: claim.claimant(claim_a10,V552) +| | | | | Fail: claim.claimant(claim_a10,V552) +| | | | Fail: check_policy_year_limit(claim_a10,preventive_care) +| | | | Call: covered_list_with_location(V556) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V556) +| | | | Fail: covered_list_with_location(V556) +| | | | Call: covered_list_with_service_provider(V557) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V557) +| | | | Fail: covered_list_with_service_provider(V557) +| | | | Call: covered_list(V558) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V558) +| | | | Fail: covered_list(V558) +| | | | Call: claim.location(claim_a10,V559) +| | | | Exit: claim.location(claim_a10,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a10,hep_b) +| | | | Fail: claim.vaccine(claim_a10,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a10,V559) +| | | | Fail: claim.location(claim_a10,V559) +| | | | Call: claim.location(claim_a10,V560) +| | | | Exit: claim.location(claim_a10,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a10,covid) +| | | | Exit: claim.vaccine(claim_a10,covid) +| | | | Call: claim.claimant(claim_a10,V561) +| | | | Exit: claim.claimant(claim_a10,person_a10) +| | | | Call: person.dob(person_a10,V562) +| | | | Exit: person.dob(person_a10,04_02_2023) +| | | | Call: claim.hosp_start_time(claim_a10,V563,V564) +| | | | Exit: claim.hosp_start_time(claim_a10,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_02_2023,V565) +| | | | | Call: evaluate(parsedate(03_09_2023),[V566,V567,V568]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V569,V570,V571]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V572) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V573) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V574) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,7),-1),V575) +| | | | | Exit: evaluate(plus(imul(31,7),-1),216) +| | | | | Call: evaluate(plus(0,if(leq(216,-1),-1,true,0)),V565) +| | | | | Exit: evaluate(plus(0,if(leq(216,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2023,V576) +| | | | | Call: evaluate(parsedate(03_09_2023),[V577,V578,V579]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V580,V581,V582]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V583) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V584) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V585) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),7),V586) +| | | | | Exit: evaluate(plus(imul(12,0),7),7) +| | | | | Call: evaluate(if(leq(-1,-1),minus(7,1),true,7),V576) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(7,1),true,7),6) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: person.immunocompromised(person_a10,V587) +| | | | Exit: person.immunocompromised(person_a10,no) +| | | | Call: claim.vaccine_brand(claim_a10,V588) +| | | | Exit: claim.vaccine_brand(claim_a10,moderna) +| | | | Call: claim.previous_vaccines_pfizer(claim_a10,V589) +| | | | Exit: claim.previous_vaccines_pfizer(claim_a10,0) +| | | | Call: claim.previous_vaccines_moderna(claim_a10,V590) +| | | | Exit: claim.previous_vaccines_moderna(claim_a10,0) +| | | | Call: claim.previous_vaccines_other(claim_a10,V591) +| | | | Exit: claim.previous_vaccines_other(claim_a10,0) +| | | | Call: age_range_limit_covid(claim_a10,V592,0,6,no,moderna,0,0,0) +| | | | | Call: leq(0,4) +| | | | | Exit: leq(0,4) +| | | | | Call: leq(6,6) +| | | | | Exit: leq(6,6) +| | | | Exit: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | Call: claim.vaccine_dose_count(claim_a10,V593) +| | | | Exit: claim.vaccine_dose_count(claim_a10,3) +| | | | Call: leq(3,2) +| | | | Fail: leq(3,2) +| | | | Redo: claim.vaccine_dose_count(claim_a10,V593) +| | | | Fail: claim.vaccine_dose_count(claim_a10,V593) +| | | | Redo: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | | Call: leq(0,4) +| | | | | Exit: leq(0,4) +| | | | | Call: leq(6,6) +| | | | | Exit: leq(6,6) +| | | | | Call: leq(1,0) +| | | | | Fail: leq(1,0) +| | | | | Call: leq(5,0) +| | | | | Fail: leq(5,0) +| | | | | Call: evaluate(plus(0,0,0),V594) +| | | | | Exit: evaluate(plus(0,0,0),0) +| | | | | Call: leq(5,0) +| | | | | Fail: leq(5,0) +| | | | Fail: age_range_limit_covid(claim_a10,V592,0,6,no,moderna,0,0,0) +| | | | Redo: claim.previous_vaccines_other(claim_a10,V591) +| | | | Fail: claim.previous_vaccines_other(claim_a10,V591) +| | | | Redo: claim.previous_vaccines_moderna(claim_a10,V590) +| | | | Fail: claim.previous_vaccines_moderna(claim_a10,V590) +| | | | Redo: claim.previous_vaccines_pfizer(claim_a10,V589) +| | | | Fail: claim.previous_vaccines_pfizer(claim_a10,V589) +| | | | Redo: claim.vaccine_brand(claim_a10,V588) +| | | | Fail: claim.vaccine_brand(claim_a10,V588) +| | | | Redo: person.immunocompromised(person_a10,V587) +| | | | Fail: person.immunocompromised(person_a10,V587) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2023,V576) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_02_2023,V565) +| | | | Redo: claim.hosp_start_time(claim_a10,V563,V564) +| | | | Fail: claim.hosp_start_time(claim_a10,V563,V564) +| | | | Redo: person.dob(person_a10,V562) +| | | | Fail: person.dob(person_a10,V562) +| | | | Redo: claim.claimant(claim_a10,V561) +| | | | Fail: claim.claimant(claim_a10,V561) +| | | | Redo: claim.vaccine(claim_a10,covid) +| | | | Fail: claim.vaccine(claim_a10,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a10,V560) +| | | | Fail: claim.location(claim_a10,V560) +| | | | Call: claim.location(claim_a10,V595) +| | | | Exit: claim.location(claim_a10,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a10,flu) +| | | | Fail: claim.vaccine(claim_a10,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a10,V595) +| | | | Fail: claim.location(claim_a10,V595) +| | | Fail: eligible_service(claim_a10,policy1,preventive_care) +| | | Redo: claim.reason(claim_a10,V551) +| | | Fail: claim.reason(claim_a10,V551) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a10,V550) +| | | Fail: claim.hospital(claim_a10,V550) +| | | Call: claim.reason(claim_a10,emergency_room) +| | | Fail: claim.reason(claim_a10,emergency_room) +| | Fail: valid_hospitalization(claim_a10,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V546) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V542) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V538) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V534) +| | | Redo: policy.enddate(policy1,person_a10,V533) +| | | Fail: policy.enddate(policy1,person_a10,V533) +| | | Redo: policy.startdate(policy1,person_a10,V532) +| | | Fail: policy.startdate(policy1,person_a10,V532) +| | | Redo: claim.hosp_end_time(claim_a10,V530,V531) +| | | Fail: claim.hosp_end_time(claim_a10,V530,V531) +| | | Redo: claim.hosp_start_time(claim_a10,V528,V529) +| | | Fail: claim.hosp_start_time(claim_a10,V528,V529) +| | | Redo: claim.claimant(claim_a10,V527) +| | | Fail: claim.claimant(claim_a10,V527) +| | Fail: policy_active(claim_a10,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a10) +| | | Fail: policy.insuree(policy1,person_a10) +| | | Redo: claim.claimant(claim_a10,V526) +| | | Fail: claim.claimant(claim_a10,V526) +| | Fail: valid_insuree(claim_a10,policy1) +| Fail: covered_under_policy(claim_a10,policy1,cardinal) +| Redo: policy.type(policy1,V454) +| Fail: policy.type(policy1,V454) +| Redo: claim.policy(X,V453) +| Exit: claim.policy(claim_a11,policy1) +| Call: policy.type(policy1,V454) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a11,policy1,cardinal) +| | Call: valid_insuree(claim_a11,policy1) +| | | Call: claim.claimant(claim_a11,V596) +| | | Exit: claim.claimant(claim_a11,person_a11) +| | | Call: policy.insuree(policy1,person_a11) +| | | Exit: policy.insuree(policy1,person_a11) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a11,policy1) +| | | Call: claim.claimant(claim_a11,V597) +| | | Exit: claim.claimant(claim_a11,person_a11) +| | | Call: claim.hosp_start_time(claim_a11,V598,V599) +| | | Exit: claim.hosp_start_time(claim_a11,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a11,V600,V601) +| | | Exit: claim.hosp_end_time(claim_a11,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a11,V602) +| | | Exit: policy.startdate(policy1,person_a11,01_08_2023) +| | | Call: policy.enddate(policy1,person_a11,V603) +| | | Exit: policy.enddate(policy1,person_a11,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V604) +| | | | Call: evaluate(parsedate(03_09_2023),[V605,V606,V607]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V604) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V608) +| | | | Call: evaluate(parsedate(03_09_2023),[V609,V610,V611]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V608) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V612) +| | | | Call: evaluate(parsedate(30_06_2024),[V613,V614,V615]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V612) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V616) +| | | | Call: evaluate(parsedate(01_08_2023),[V617,V618,V619]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V616) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a11,policy1) +| | | Call: claim.hospital(claim_a11,V620) +| | | Exit: claim.hospital(claim_a11,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a11,V621) +| | | Exit: claim.reason(claim_a11,preventive_care) +| | | Call: eligible_service(claim_a11,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a11,preventive_care) +| | | | | Call: claim.claimant(claim_a11,V622) +| | | | | Exit: claim.claimant(claim_a11,person_a11) +| | | | | Call: person.dob(person_a11,V623) +| | | | | Exit: person.dob(person_a11,04_02_2011) +| | | | | Call: claim.time(claim_a11,V624,V625) +| | | | | Fail: claim.time(claim_a11,V624,V625) +| | | | | Redo: person.dob(person_a11,V623) +| | | | | Fail: person.dob(person_a11,V623) +| | | | | Redo: claim.claimant(claim_a11,V622) +| | | | | Fail: claim.claimant(claim_a11,V622) +| | | | Fail: check_policy_year_limit(claim_a11,preventive_care) +| | | | Call: covered_list_with_location(V626) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V626) +| | | | Fail: covered_list_with_location(V626) +| | | | Call: covered_list_with_service_provider(V627) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V627) +| | | | Fail: covered_list_with_service_provider(V627) +| | | | Call: covered_list(V628) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V628) +| | | | Fail: covered_list(V628) +| | | | Call: claim.location(claim_a11,V629) +| | | | Exit: claim.location(claim_a11,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a11,hep_b) +| | | | Fail: claim.vaccine(claim_a11,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a11,V629) +| | | | Fail: claim.location(claim_a11,V629) +| | | | Call: claim.location(claim_a11,V630) +| | | | Exit: claim.location(claim_a11,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a11,covid) +| | | | Exit: claim.vaccine(claim_a11,covid) +| | | | Call: claim.claimant(claim_a11,V631) +| | | | Exit: claim.claimant(claim_a11,person_a11) +| | | | Call: person.dob(person_a11,V632) +| | | | Exit: person.dob(person_a11,04_02_2011) +| | | | Call: claim.hosp_start_time(claim_a11,V633,V634) +| | | | Exit: claim.hosp_start_time(claim_a11,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_02_2011,V635) +| | | | | Call: evaluate(parsedate(03_09_2023),[V636,V637,V638]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2011),[V639,V640,V641]) +| | | | | Exit: evaluate(parsedate(04_02_2011),[04,02,2011]) +| | | | | Call: evaluate(minus(2023,2011),V642) +| | | | | Exit: evaluate(minus(2023,2011),12) +| | | | | Call: evaluate(minus(09,02),V643) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V644) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,7),-1),V645) +| | | | | Exit: evaluate(plus(imul(31,7),-1),216) +| | | | | Call: evaluate(plus(12,if(leq(216,-1),-1,true,0)),V635) +| | | | | Exit: evaluate(plus(12,if(leq(216,-1),-1,true,0)),12) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2011,V646) +| | | | | Call: evaluate(parsedate(03_09_2023),[V647,V648,V649]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2011),[V650,V651,V652]) +| | | | | Exit: evaluate(parsedate(04_02_2011),[04,02,2011]) +| | | | | Call: evaluate(minus(2023,2011),V653) +| | | | | Exit: evaluate(minus(2023,2011),12) +| | | | | Call: evaluate(minus(09,02),V654) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V655) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,12),7),V656) +| | | | | Exit: evaluate(plus(imul(12,12),7),151) +| | | | | Call: evaluate(if(leq(-1,-1),minus(151,1),true,151),V646) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(151,1),true,151),150) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: person.immunocompromised(person_a11,V657) +| | | | Exit: person.immunocompromised(person_a11,yes) +| | | | Call: claim.vaccine_brand(claim_a11,V658) +| | | | Exit: claim.vaccine_brand(claim_a11,moderna) +| | | | Call: claim.previous_vaccines_pfizer(claim_a11,V659) +| | | | Exit: claim.previous_vaccines_pfizer(claim_a11,0) +| | | | Call: claim.previous_vaccines_moderna(claim_a11,V660) +| | | | Exit: claim.previous_vaccines_moderna(claim_a11,0) +| | | | Call: claim.previous_vaccines_other(claim_a11,V661) +| | | | Exit: claim.previous_vaccines_other(claim_a11,1) +| | | | Call: age_range_limit_covid(claim_a11,V662,12,150,yes,moderna,0,0,1) +| | | | | Call: leq(6,150) +| | | | | Exit: leq(6,150) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(12,12) +| | | | | Exit: leq(12,12) +| | | | | Call: leq(1,1) +| | | | | Exit: leq(1,1) +| | | | Exit: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | Call: claim.vaccine_dose_count(claim_a11,V663) +| | | | Exit: claim.vaccine_dose_count(claim_a11,1) +| | | | Call: leq(1,1) +| | | | Exit: leq(1,1) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a11,policy1) +Call: exception(claim_a11,policy1) +| Call: claim.claimant(claim_a11,V664) +| Exit: claim.claimant(claim_a11,person_a11) +| Call: person.occupation(person_a11,armed_forces) +| Fail: person.occupation(person_a11,armed_forces) +| Redo: claim.claimant(claim_a11,V664) +| Fail: claim.claimant(claim_a11,V664) +| Call: claim.reason(claim_a11,home_health_care) +| Fail: claim.reason(claim_a11,home_health_care) +| Call: claim.reason(claim_a11,home_health_care) +| Fail: claim.reason(claim_a11,home_health_care) +Fail: exception(claim_a11,policy1) +| | | Exit: ~exception(claim_a11,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a11) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: claim.vaccine_dose_count(claim_a11,V663) +| | | | Fail: claim.vaccine_dose_count(claim_a11,V663) +| | | | Redo: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | Fail: age_range_limit_covid(claim_a11,V662,12,150,yes,moderna,0,0,1) +| | | | Redo: claim.previous_vaccines_other(claim_a11,V661) +| | | | Fail: claim.previous_vaccines_other(claim_a11,V661) +| | | | Redo: claim.previous_vaccines_moderna(claim_a11,V660) +| | | | Fail: claim.previous_vaccines_moderna(claim_a11,V660) +| | | | Redo: claim.previous_vaccines_pfizer(claim_a11,V659) +| | | | Fail: claim.previous_vaccines_pfizer(claim_a11,V659) +| | | | Redo: claim.vaccine_brand(claim_a11,V658) +| | | | Fail: claim.vaccine_brand(claim_a11,V658) +| | | | Redo: person.immunocompromised(person_a11,V657) +| | | | Fail: person.immunocompromised(person_a11,V657) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2011,V646) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_02_2011,V635) +| | | | Redo: claim.hosp_start_time(claim_a11,V633,V634) +| | | | Fail: claim.hosp_start_time(claim_a11,V633,V634) +| | | | Redo: person.dob(person_a11,V632) +| | | | Fail: person.dob(person_a11,V632) +| | | | Redo: claim.claimant(claim_a11,V631) +| | | | Fail: claim.claimant(claim_a11,V631) +| | | | Redo: claim.vaccine(claim_a11,covid) +| | | | Fail: claim.vaccine(claim_a11,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a11,V630) +| | | | Fail: claim.location(claim_a11,V630) +| | | | Call: claim.location(claim_a11,V665) +| | | | Exit: claim.location(claim_a11,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a11,flu) +| | | | Fail: claim.vaccine(claim_a11,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a11,V665) +| | | | Fail: claim.location(claim_a11,V665) +| | | Fail: eligible_service(claim_a11,policy1,preventive_care) +| | | Redo: claim.reason(claim_a11,V621) +| | | Fail: claim.reason(claim_a11,V621) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a11,V620) +| | | Fail: claim.hospital(claim_a11,V620) +| | | Call: claim.reason(claim_a11,emergency_room) +| | | Fail: claim.reason(claim_a11,emergency_room) +| | Fail: valid_hospitalization(claim_a11,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V616) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V612) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V608) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V604) +| | | Redo: policy.enddate(policy1,person_a11,V603) +| | | Fail: policy.enddate(policy1,person_a11,V603) +| | | Redo: policy.startdate(policy1,person_a11,V602) +| | | Fail: policy.startdate(policy1,person_a11,V602) +| | | Redo: claim.hosp_end_time(claim_a11,V600,V601) +| | | Fail: claim.hosp_end_time(claim_a11,V600,V601) +| | | Redo: claim.hosp_start_time(claim_a11,V598,V599) +| | | Fail: claim.hosp_start_time(claim_a11,V598,V599) +| | | Redo: claim.claimant(claim_a11,V597) +| | | Fail: claim.claimant(claim_a11,V597) +| | Fail: policy_active(claim_a11,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a11) +| | | Fail: policy.insuree(policy1,person_a11) +| | | Redo: claim.claimant(claim_a11,V596) +| | | Fail: claim.claimant(claim_a11,V596) +| | Fail: valid_insuree(claim_a11,policy1) +| Fail: covered_under_policy(claim_a11,policy1,cardinal) +| Redo: policy.type(policy1,V454) +| Fail: policy.type(policy1,V454) +| Redo: claim.policy(X,V453) +| Exit: claim.policy(claim_a12,policy1) +| Call: policy.type(policy1,V454) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a12,policy1,cardinal) +| | Call: valid_insuree(claim_a12,policy1) +| | | Call: claim.claimant(claim_a12,V666) +| | | Exit: claim.claimant(claim_a12,person_a12) +| | | Call: policy.insuree(policy1,person_a12) +| | | Exit: policy.insuree(policy1,person_a12) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a12,policy1) +| | | Call: claim.claimant(claim_a12,V667) +| | | Exit: claim.claimant(claim_a12,person_a12) +| | | Call: claim.hosp_start_time(claim_a12,V668,V669) +| | | Exit: claim.hosp_start_time(claim_a12,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a12,V670,V671) +| | | Exit: claim.hosp_end_time(claim_a12,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a12,V672) +| | | Exit: policy.startdate(policy1,person_a12,01_08_2023) +| | | Call: policy.enddate(policy1,person_a12,V673) +| | | Exit: policy.enddate(policy1,person_a12,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V674) +| | | | Call: evaluate(parsedate(03_09_2023),[V675,V676,V677]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V674) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V678) +| | | | Call: evaluate(parsedate(03_09_2023),[V679,V680,V681]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V678) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V682) +| | | | Call: evaluate(parsedate(30_06_2024),[V683,V684,V685]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V682) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V686) +| | | | Call: evaluate(parsedate(01_08_2023),[V687,V688,V689]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V686) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a12,policy1) +| | | Call: claim.hospital(claim_a12,V690) +| | | Exit: claim.hospital(claim_a12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a12,V691) +| | | Exit: claim.reason(claim_a12,preventive_care) +| | | Call: eligible_service(claim_a12,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a12,preventive_care) +| | | | | Call: claim.claimant(claim_a12,V692) +| | | | | Exit: claim.claimant(claim_a12,person_a12) +| | | | | Call: person.dob(person_a12,V693) +| | | | | Exit: person.dob(person_a12,04_02_2011) +| | | | | Call: claim.time(claim_a12,V694,V695) +| | | | | Fail: claim.time(claim_a12,V694,V695) +| | | | | Redo: person.dob(person_a12,V693) +| | | | | Fail: person.dob(person_a12,V693) +| | | | | Redo: claim.claimant(claim_a12,V692) +| | | | | Fail: claim.claimant(claim_a12,V692) +| | | | Fail: check_policy_year_limit(claim_a12,preventive_care) +| | | | Call: covered_list_with_location(V696) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V696) +| | | | Fail: covered_list_with_location(V696) +| | | | Call: covered_list_with_service_provider(V697) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V697) +| | | | Fail: covered_list_with_service_provider(V697) +| | | | Call: covered_list(V698) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V698) +| | | | Fail: covered_list(V698) +| | | | Call: claim.location(claim_a12,V699) +| | | | Exit: claim.location(claim_a12,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a12,hep_b) +| | | | Fail: claim.vaccine(claim_a12,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a12,V699) +| | | | Fail: claim.location(claim_a12,V699) +| | | | Call: claim.location(claim_a12,V700) +| | | | Exit: claim.location(claim_a12,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a12,covid) +| | | | Exit: claim.vaccine(claim_a12,covid) +| | | | Call: claim.claimant(claim_a12,V701) +| | | | Exit: claim.claimant(claim_a12,person_a12) +| | | | Call: person.dob(person_a12,V702) +| | | | Exit: person.dob(person_a12,04_02_2011) +| | | | Call: claim.hosp_start_time(claim_a12,V703,V704) +| | | | Exit: claim.hosp_start_time(claim_a12,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_02_2011,V705) +| | | | | Call: evaluate(parsedate(03_09_2023),[V706,V707,V708]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2011),[V709,V710,V711]) +| | | | | Exit: evaluate(parsedate(04_02_2011),[04,02,2011]) +| | | | | Call: evaluate(minus(2023,2011),V712) +| | | | | Exit: evaluate(minus(2023,2011),12) +| | | | | Call: evaluate(minus(09,02),V713) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V714) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,7),-1),V715) +| | | | | Exit: evaluate(plus(imul(31,7),-1),216) +| | | | | Call: evaluate(plus(12,if(leq(216,-1),-1,true,0)),V705) +| | | | | Exit: evaluate(plus(12,if(leq(216,-1),-1,true,0)),12) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2011,V716) +| | | | | Call: evaluate(parsedate(03_09_2023),[V717,V718,V719]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2011),[V720,V721,V722]) +| | | | | Exit: evaluate(parsedate(04_02_2011),[04,02,2011]) +| | | | | Call: evaluate(minus(2023,2011),V723) +| | | | | Exit: evaluate(minus(2023,2011),12) +| | | | | Call: evaluate(minus(09,02),V724) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V725) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,12),7),V726) +| | | | | Exit: evaluate(plus(imul(12,12),7),151) +| | | | | Call: evaluate(if(leq(-1,-1),minus(151,1),true,151),V716) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(151,1),true,151),150) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: person.immunocompromised(person_a12,V727) +| | | | Exit: person.immunocompromised(person_a12,yes) +| | | | Call: claim.vaccine_brand(claim_a12,V728) +| | | | Exit: claim.vaccine_brand(claim_a12,moderna) +| | | | Call: claim.previous_vaccines_pfizer(claim_a12,V729) +| | | | Exit: claim.previous_vaccines_pfizer(claim_a12,0) +| | | | Call: claim.previous_vaccines_moderna(claim_a12,V730) +| | | | Exit: claim.previous_vaccines_moderna(claim_a12,0) +| | | | Call: claim.previous_vaccines_other(claim_a12,V731) +| | | | Exit: claim.previous_vaccines_other(claim_a12,1) +| | | | Call: age_range_limit_covid(claim_a12,V732,12,150,yes,moderna,0,0,1) +| | | | | Call: leq(6,150) +| | | | | Exit: leq(6,150) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(12,12) +| | | | | Exit: leq(12,12) +| | | | | Call: leq(1,1) +| | | | | Exit: leq(1,1) +| | | | Exit: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | Call: claim.vaccine_dose_count(claim_a12,V733) +| | | | Exit: claim.vaccine_dose_count(claim_a12,2) +| | | | Call: leq(2,1) +| | | | Fail: leq(2,1) +| | | | Redo: claim.vaccine_dose_count(claim_a12,V733) +| | | | Fail: claim.vaccine_dose_count(claim_a12,V733) +| | | | Redo: age_range_limit_covid(C,N,Y,M,Immuno_Status,Type,Count_P,Count_M,Count_O) +| | | | Fail: age_range_limit_covid(claim_a12,V732,12,150,yes,moderna,0,0,1) +| | | | Redo: claim.previous_vaccines_other(claim_a12,V731) +| | | | Fail: claim.previous_vaccines_other(claim_a12,V731) +| | | | Redo: claim.previous_vaccines_moderna(claim_a12,V730) +| | | | Fail: claim.previous_vaccines_moderna(claim_a12,V730) +| | | | Redo: claim.previous_vaccines_pfizer(claim_a12,V729) +| | | | Fail: claim.previous_vaccines_pfizer(claim_a12,V729) +| | | | Redo: claim.vaccine_brand(claim_a12,V728) +| | | | Fail: claim.vaccine_brand(claim_a12,V728) +| | | | Redo: person.immunocompromised(person_a12,V727) +| | | | Fail: person.immunocompromised(person_a12,V727) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2011,V716) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_02_2011,V705) +| | | | Redo: claim.hosp_start_time(claim_a12,V703,V704) +| | | | Fail: claim.hosp_start_time(claim_a12,V703,V704) +| | | | Redo: person.dob(person_a12,V702) +| | | | Fail: person.dob(person_a12,V702) +| | | | Redo: claim.claimant(claim_a12,V701) +| | | | Fail: claim.claimant(claim_a12,V701) +| | | | Redo: claim.vaccine(claim_a12,covid) +| | | | Fail: claim.vaccine(claim_a12,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a12,V700) +| | | | Fail: claim.location(claim_a12,V700) +| | | | Call: claim.location(claim_a12,V734) +| | | | Exit: claim.location(claim_a12,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a12,flu) +| | | | Fail: claim.vaccine(claim_a12,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a12,V734) +| | | | Fail: claim.location(claim_a12,V734) +| | | Fail: eligible_service(claim_a12,policy1,preventive_care) +| | | Redo: claim.reason(claim_a12,V691) +| | | Fail: claim.reason(claim_a12,V691) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a12,V690) +| | | Fail: claim.hospital(claim_a12,V690) +| | | Call: claim.reason(claim_a12,emergency_room) +| | | Fail: claim.reason(claim_a12,emergency_room) +| | Fail: valid_hospitalization(claim_a12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V686) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V682) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V678) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V674) +| | | Redo: policy.enddate(policy1,person_a12,V673) +| | | Fail: policy.enddate(policy1,person_a12,V673) +| | | Redo: policy.startdate(policy1,person_a12,V672) +| | | Fail: policy.startdate(policy1,person_a12,V672) +| | | Redo: claim.hosp_end_time(claim_a12,V670,V671) +| | | Fail: claim.hosp_end_time(claim_a12,V670,V671) +| | | Redo: claim.hosp_start_time(claim_a12,V668,V669) +| | | Fail: claim.hosp_start_time(claim_a12,V668,V669) +| | | Redo: claim.claimant(claim_a12,V667) +| | | Fail: claim.claimant(claim_a12,V667) +| | Fail: policy_active(claim_a12,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a12) +| | | Fail: policy.insuree(policy1,person_a12) +| | | Redo: claim.claimant(claim_a12,V666) +| | | Fail: claim.claimant(claim_a12,V666) +| | Fail: valid_insuree(claim_a12,policy1) +| Fail: covered_under_policy(claim_a12,policy1,cardinal) +| Redo: policy.type(policy1,V454) +| Fail: policy.type(policy1,V454) +| Redo: claim.policy(X,V453) +| Exit: claim.policy(claim_a13,policy1) +| Call: policy.type(policy1,V454) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a13,policy1,cardinal) +| | Call: valid_insuree(claim_a13,policy1) +| | | Call: claim.claimant(claim_a13,V735) +| | | Exit: claim.claimant(claim_a13,person_a13) +| | | Call: policy.insuree(policy1,person_a13) +| | | Exit: policy.insuree(policy1,person_a13) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a13,policy1) +| | | Call: claim.claimant(claim_a13,V736) +| | | Exit: claim.claimant(claim_a13,person_a13) +| | | Call: claim.hosp_start_time(claim_a13,V737,V738) +| | | Exit: claim.hosp_start_time(claim_a13,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a13,V739,V740) +| | | Exit: claim.hosp_end_time(claim_a13,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a13,V741) +| | | Exit: policy.startdate(policy1,person_a13,01_08_2023) +| | | Call: policy.enddate(policy1,person_a13,V742) +| | | Exit: policy.enddate(policy1,person_a13,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V743) +| | | | Call: evaluate(parsedate(03_09_2023),[V744,V745,V746]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V743) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V747) +| | | | Call: evaluate(parsedate(03_09_2023),[V748,V749,V750]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V747) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V751) +| | | | Call: evaluate(parsedate(30_06_2024),[V752,V753,V754]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V751) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V755) +| | | | Call: evaluate(parsedate(01_08_2023),[V756,V757,V758]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V755) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a13,policy1) +| | | Call: claim.hospital(claim_a13,V759) +| | | Exit: claim.hospital(claim_a13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a13,V760) +| | | Exit: claim.reason(claim_a13,preventive_care) +| | | Call: eligible_service(claim_a13,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a13,preventive_care) +| | | | | Call: claim.claimant(claim_a13,V761) +| | | | | Exit: claim.claimant(claim_a13,person_a13) +| | | | | Call: person.dob(person_a13,V762) +| | | | | Exit: person.dob(person_a13,04_02_2012) +| | | | | Call: claim.time(claim_a13,V763,V764) +| | | | | Fail: claim.time(claim_a13,V763,V764) +| | | | | Redo: person.dob(person_a13,V762) +| | | | | Fail: person.dob(person_a13,V762) +| | | | | Redo: claim.claimant(claim_a13,V761) +| | | | | Fail: claim.claimant(claim_a13,V761) +| | | | Fail: check_policy_year_limit(claim_a13,preventive_care) +| | | | Call: covered_list_with_location(V765) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V765) +| | | | Fail: covered_list_with_location(V765) +| | | | Call: covered_list_with_service_provider(V766) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V766) +| | | | Fail: covered_list_with_service_provider(V766) +| | | | Call: covered_list(V767) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V767) +| | | | Fail: covered_list(V767) +| | | | Call: claim.location(claim_a13,V768) +| | | | Exit: claim.location(claim_a13,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a13,hep_b) +| | | | Fail: claim.vaccine(claim_a13,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a13,V768) +| | | | Fail: claim.location(claim_a13,V768) +| | | | Call: claim.location(claim_a13,V769) +| | | | Exit: claim.location(claim_a13,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a13,covid) +| | | | Exit: claim.vaccine(claim_a13,covid) +| | | | Call: claim.claimant(claim_a13,V770) +| | | | Exit: claim.claimant(claim_a13,person_a13) +| | | | Call: person.dob(person_a13,V771) +| | | | Exit: person.dob(person_a13,04_02_2012) +| | | | Call: claim.hosp_start_time(claim_a13,V772,V773) +| | | | Exit: claim.hosp_start_time(claim_a13,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_02_2012,V774) +| | | | | Call: evaluate(parsedate(03_09_2023),[V775,V776,V777]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2012),[V778,V779,V780]) +| | | | | Exit: evaluate(parsedate(04_02_2012),[04,02,2012]) +| | | | | Call: evaluate(minus(2023,2012),V781) +| | | | | Exit: evaluate(minus(2023,2012),11) +| | | | | Call: evaluate(minus(09,02),V782) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V783) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,7),-1),V784) +| | | | | Exit: evaluate(plus(imul(31,7),-1),216) +| | | | | Call: evaluate(plus(11,if(leq(216,-1),-1,true,0)),V774) +| | | | | Exit: evaluate(plus(11,if(leq(216,-1),-1,true,0)),11) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2012,V785) +| | | | | Call: evaluate(parsedate(03_09_2023),[V786,V787,V788]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2012),[V789,V790,V791]) +| | | | | Exit: evaluate(parsedate(04_02_2012),[04,02,2012]) +| | | | | Call: evaluate(minus(2023,2012),V792) +| | | | | Exit: evaluate(minus(2023,2012),11) +| | | | | Call: evaluate(minus(09,02),V793) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V794) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,11),7),V795) +| | | | | Exit: evaluate(plus(imul(12,11),7),139) +| | | | | Call: evaluate(if(leq(-1,-1),minus(139,1),true,139),V785) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(139,1),true,139),138) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: person.immunocompromised(person_a13,V796) +| | | | Exit: person.immunocompromised(person_a13,yes) +| | | | Call: claim.vaccine_brand(claim_a13,V797) +| | | | Exit: claim.vaccine_brand(claim_a13,moderna) +| | | | Call: claim.previous_vaccines_pfizer(claim_a13,V798) +| | | | Exit: claim.previous_vaccines_pfizer(claim_a13,0) +| | | | Call: claim.previous_vaccines_moderna(claim_a13,V799) +| | | | Exit: claim.previous_vaccines_moderna(claim_a13,0) +| | | | Call: claim.previous_vaccines_other(claim_a13,V800) +| | | | Exit: claim.previous_vaccines_other(claim_a13,1) +| | | | Call: age_range_limit_covid(claim_a13,V801,11,138,yes,moderna,0,0,1) +| | | | | Call: leq(6,138) +| | | | | Exit: leq(6,138) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(12,11) +| | | | | Fail: leq(12,11) +| | | | Fail: age_range_limit_covid(claim_a13,V801,11,138,yes,moderna,0,0,1) +| | | | Redo: claim.previous_vaccines_other(claim_a13,V800) +| | | | Fail: claim.previous_vaccines_other(claim_a13,V800) +| | | | Redo: claim.previous_vaccines_moderna(claim_a13,V799) +| | | | Fail: claim.previous_vaccines_moderna(claim_a13,V799) +| | | | Redo: claim.previous_vaccines_pfizer(claim_a13,V798) +| | | | Fail: claim.previous_vaccines_pfizer(claim_a13,V798) +| | | | Redo: claim.vaccine_brand(claim_a13,V797) +| | | | Fail: claim.vaccine_brand(claim_a13,V797) +| | | | Redo: person.immunocompromised(person_a13,V796) +| | | | Fail: person.immunocompromised(person_a13,V796) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2012,V785) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_02_2012,V774) +| | | | Redo: claim.hosp_start_time(claim_a13,V772,V773) +| | | | Fail: claim.hosp_start_time(claim_a13,V772,V773) +| | | | Redo: person.dob(person_a13,V771) +| | | | Fail: person.dob(person_a13,V771) +| | | | Redo: claim.claimant(claim_a13,V770) +| | | | Fail: claim.claimant(claim_a13,V770) +| | | | Redo: claim.vaccine(claim_a13,covid) +| | | | Fail: claim.vaccine(claim_a13,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a13,V769) +| | | | Fail: claim.location(claim_a13,V769) +| | | | Call: claim.location(claim_a13,V802) +| | | | Exit: claim.location(claim_a13,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a13,flu) +| | | | Fail: claim.vaccine(claim_a13,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a13,V802) +| | | | Fail: claim.location(claim_a13,V802) +| | | Fail: eligible_service(claim_a13,policy1,preventive_care) +| | | Redo: claim.reason(claim_a13,V760) +| | | Fail: claim.reason(claim_a13,V760) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a13,V759) +| | | Fail: claim.hospital(claim_a13,V759) +| | | Call: claim.reason(claim_a13,emergency_room) +| | | Fail: claim.reason(claim_a13,emergency_room) +| | Fail: valid_hospitalization(claim_a13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V755) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V751) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V747) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V743) +| | | Redo: policy.enddate(policy1,person_a13,V742) +| | | Fail: policy.enddate(policy1,person_a13,V742) +| | | Redo: policy.startdate(policy1,person_a13,V741) +| | | Fail: policy.startdate(policy1,person_a13,V741) +| | | Redo: claim.hosp_end_time(claim_a13,V739,V740) +| | | Fail: claim.hosp_end_time(claim_a13,V739,V740) +| | | Redo: claim.hosp_start_time(claim_a13,V737,V738) +| | | Fail: claim.hosp_start_time(claim_a13,V737,V738) +| | | Redo: claim.claimant(claim_a13,V736) +| | | Fail: claim.claimant(claim_a13,V736) +| | Fail: policy_active(claim_a13,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a13) +| | | Fail: policy.insuree(policy1,person_a13) +| | | Redo: claim.claimant(claim_a13,V735) +| | | Fail: claim.claimant(claim_a13,V735) +| | Fail: valid_insuree(claim_a13,policy1) +| Fail: covered_under_policy(claim_a13,policy1,cardinal) +| Redo: policy.type(policy1,V454) +| Fail: policy.type(policy1,V454) +| Redo: claim.policy(X,V453) +| Fail: claim.policy(X,V453) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_covid.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim_a9', 'claim_a11' ] +RESULTS: [ 'claim_a9', 'claim_a11' ] +===== TEST SUCCEEDED: Test test_cases_covid.hdf===== +Expected Result: [ 'claim_a14', 'claim_a17' ] +Call: covered(X) +| Call: claim.policy(X,V803) +| Exit: claim.policy(claim_a14,policy1) +| Call: policy.type(policy1,V804) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a14,policy1,cardinal) +| | Call: valid_insuree(claim_a14,policy1) +| | | Call: claim.claimant(claim_a14,V805) +| | | Exit: claim.claimant(claim_a14,person_a14) +| | | Call: policy.insuree(policy1,person_a14) +| | | Exit: policy.insuree(policy1,person_a14) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a14,policy1) +| | | Call: claim.claimant(claim_a14,V806) +| | | Exit: claim.claimant(claim_a14,person_a14) +| | | Call: claim.hosp_start_time(claim_a14,V807,V808) +| | | Exit: claim.hosp_start_time(claim_a14,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a14,V809,V810) +| | | Exit: claim.hosp_end_time(claim_a14,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a14,V811) +| | | Exit: policy.startdate(policy1,person_a14,01_08_2023) +| | | Call: policy.enddate(policy1,person_a14,V812) +| | | Exit: policy.enddate(policy1,person_a14,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V813) +| | | | Call: evaluate(parsedate(03_09_2023),[V814,V815,V816]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V813) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V817) +| | | | Call: evaluate(parsedate(03_09_2023),[V818,V819,V820]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V817) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V821) +| | | | Call: evaluate(parsedate(30_06_2024),[V822,V823,V824]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V821) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V825) +| | | | Call: evaluate(parsedate(01_08_2023),[V826,V827,V828]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V825) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a14,policy1) +| | | Call: claim.hospital(claim_a14,V829) +| | | Exit: claim.hospital(claim_a14,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a14,V830) +| | | Exit: claim.reason(claim_a14,preventive_care) +| | | Call: eligible_service(claim_a14,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a14,preventive_care) +| | | | | Call: claim.claimant(claim_a14,V831) +| | | | | Exit: claim.claimant(claim_a14,person_a14) +| | | | | Call: person.dob(person_a14,V832) +| | | | | Exit: person.dob(person_a14,04_02_2023) +| | | | | Call: claim.time(claim_a14,V833,V834) +| | | | | Fail: claim.time(claim_a14,V833,V834) +| | | | | Redo: person.dob(person_a14,V832) +| | | | | Fail: person.dob(person_a14,V832) +| | | | | Redo: claim.claimant(claim_a14,V831) +| | | | | Fail: claim.claimant(claim_a14,V831) +| | | | Fail: check_policy_year_limit(claim_a14,preventive_care) +| | | | Call: covered_list_with_location(V835) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V835) +| | | | Fail: covered_list_with_location(V835) +| | | | Call: covered_list_with_service_provider(V836) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V836) +| | | | Fail: covered_list_with_service_provider(V836) +| | | | Call: covered_list(V837) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V837) +| | | | Fail: covered_list(V837) +| | | | Call: claim.location(claim_a14,V838) +| | | | Exit: claim.location(claim_a14,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a14,hep_b) +| | | | Fail: claim.vaccine(claim_a14,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a14,V838) +| | | | Fail: claim.location(claim_a14,V838) +| | | | Call: claim.location(claim_a14,V839) +| | | | Exit: claim.location(claim_a14,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a14,covid) +| | | | Fail: claim.vaccine(claim_a14,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a14,V839) +| | | | Fail: claim.location(claim_a14,V839) +| | | | Call: claim.location(claim_a14,V840) +| | | | Exit: claim.location(claim_a14,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a14,flu) +| | | | Exit: claim.vaccine(claim_a14,flu) +| | | | Call: claim.claimant(claim_a14,V841) +| | | | Exit: claim.claimant(claim_a14,person_a14) +| | | | Call: person.dob(person_a14,V842) +| | | | Exit: person.dob(person_a14,04_02_2023) +| | | | Call: claim.hosp_start_time(claim_a14,V843,V844) +| | | | Exit: claim.hosp_start_time(claim_a14,03_09_2023,00_00) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2023,V845) +| | | | | Call: evaluate(parsedate(03_09_2023),[V846,V847,V848]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V849,V850,V851]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V852) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V853) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V854) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),7),V855) +| | | | | Exit: evaluate(plus(imul(12,0),7),7) +| | | | | Call: evaluate(if(leq(-1,-1),minus(7,1),true,7),V845) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(7,1),true,7),6) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: claim.previous_vaccines_flu_more_than_equal_2(claim_a14,V856) +| | | | Exit: claim.previous_vaccines_flu_more_than_equal_2(claim_a14,no) +| | | | Call: age_range_limit_flu(claim_a14,V857,V858,V859,no) +| | | | Exit: age_range_limit_flu(C,1,0,20000,PC) +| | | | Call: leq(0,6) +| | | | Exit: leq(0,6) +| | | | Call: leq(6,20000) +| | | | Exit: leq(6,20000) +| | | | Call: claim.vaccine_dose_count_annual(claim_a14,V860) +| | | | Exit: claim.vaccine_dose_count_annual(claim_a14,2) +| | | | Call: leq(2,1) +| | | | Fail: leq(2,1) +| | | | Redo: claim.vaccine_dose_count_annual(claim_a14,V860) +| | | | Fail: claim.vaccine_dose_count_annual(claim_a14,V860) +| | | | Redo: age_range_limit_flu(claim_a14,V857,V858,V859,no) +| | | | Exit: age_range_limit_flu(C,2,6,96,no) +| | | | Call: leq(6,6) +| | | | Exit: leq(6,6) +| | | | Call: leq(6,96) +| | | | Exit: leq(6,96) +| | | | Call: claim.vaccine_dose_count_annual(claim_a14,V860) +| | | | Exit: claim.vaccine_dose_count_annual(claim_a14,2) +| | | | Call: leq(2,2) +| | | | Exit: leq(2,2) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a14,policy1) +Call: exception(claim_a14,policy1) +| Call: claim.claimant(claim_a14,V861) +| Exit: claim.claimant(claim_a14,person_a14) +| Call: person.occupation(person_a14,armed_forces) +| Fail: person.occupation(person_a14,armed_forces) +| Redo: claim.claimant(claim_a14,V861) +| Fail: claim.claimant(claim_a14,V861) +| Call: claim.reason(claim_a14,home_health_care) +| Fail: claim.reason(claim_a14,home_health_care) +| Call: claim.reason(claim_a14,home_health_care) +| Fail: claim.reason(claim_a14,home_health_care) +Fail: exception(claim_a14,policy1) +| | | Exit: ~exception(claim_a14,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a14) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: claim.vaccine_dose_count_annual(claim_a14,V860) +| | | | Fail: claim.vaccine_dose_count_annual(claim_a14,V860) +| | | | Redo: age_range_limit_flu(claim_a14,V857,V858,V859,no) +| | | | Fail: age_range_limit_flu(claim_a14,V857,V858,V859,no) +| | | | Redo: claim.previous_vaccines_flu_more_than_equal_2(claim_a14,V856) +| | | | Fail: claim.previous_vaccines_flu_more_than_equal_2(claim_a14,V856) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2023,V845) +| | | | Redo: claim.hosp_start_time(claim_a14,V843,V844) +| | | | Fail: claim.hosp_start_time(claim_a14,V843,V844) +| | | | Redo: person.dob(person_a14,V842) +| | | | Fail: person.dob(person_a14,V842) +| | | | Redo: claim.claimant(claim_a14,V841) +| | | | Fail: claim.claimant(claim_a14,V841) +| | | | Redo: claim.vaccine(claim_a14,flu) +| | | | Fail: claim.vaccine(claim_a14,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a14,V840) +| | | | Fail: claim.location(claim_a14,V840) +| | | Fail: eligible_service(claim_a14,policy1,preventive_care) +| | | Redo: claim.reason(claim_a14,V830) +| | | Fail: claim.reason(claim_a14,V830) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a14,V829) +| | | Fail: claim.hospital(claim_a14,V829) +| | | Call: claim.reason(claim_a14,emergency_room) +| | | Fail: claim.reason(claim_a14,emergency_room) +| | Fail: valid_hospitalization(claim_a14,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V825) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V821) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V817) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V813) +| | | Redo: policy.enddate(policy1,person_a14,V812) +| | | Fail: policy.enddate(policy1,person_a14,V812) +| | | Redo: policy.startdate(policy1,person_a14,V811) +| | | Fail: policy.startdate(policy1,person_a14,V811) +| | | Redo: claim.hosp_end_time(claim_a14,V809,V810) +| | | Fail: claim.hosp_end_time(claim_a14,V809,V810) +| | | Redo: claim.hosp_start_time(claim_a14,V807,V808) +| | | Fail: claim.hosp_start_time(claim_a14,V807,V808) +| | | Redo: claim.claimant(claim_a14,V806) +| | | Fail: claim.claimant(claim_a14,V806) +| | Fail: policy_active(claim_a14,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a14) +| | | Fail: policy.insuree(policy1,person_a14) +| | | Redo: claim.claimant(claim_a14,V805) +| | | Fail: claim.claimant(claim_a14,V805) +| | Fail: valid_insuree(claim_a14,policy1) +| Fail: covered_under_policy(claim_a14,policy1,cardinal) +| Redo: policy.type(policy1,V804) +| Fail: policy.type(policy1,V804) +| Redo: claim.policy(X,V803) +| Exit: claim.policy(claim_a15,policy1) +| Call: policy.type(policy1,V804) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a15,policy1,cardinal) +| | Call: valid_insuree(claim_a15,policy1) +| | | Call: claim.claimant(claim_a15,V862) +| | | Exit: claim.claimant(claim_a15,person_a15) +| | | Call: policy.insuree(policy1,person_a15) +| | | Exit: policy.insuree(policy1,person_a15) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a15,policy1) +| | | Call: claim.claimant(claim_a15,V863) +| | | Exit: claim.claimant(claim_a15,person_a15) +| | | Call: claim.hosp_start_time(claim_a15,V864,V865) +| | | Exit: claim.hosp_start_time(claim_a15,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a15,V866,V867) +| | | Exit: claim.hosp_end_time(claim_a15,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a15,V868) +| | | Exit: policy.startdate(policy1,person_a15,01_08_2023) +| | | Call: policy.enddate(policy1,person_a15,V869) +| | | Exit: policy.enddate(policy1,person_a15,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V870) +| | | | Call: evaluate(parsedate(03_09_2023),[V871,V872,V873]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V870) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V874) +| | | | Call: evaluate(parsedate(03_09_2023),[V875,V876,V877]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V874) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V878) +| | | | Call: evaluate(parsedate(30_06_2024),[V879,V880,V881]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V878) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V882) +| | | | Call: evaluate(parsedate(01_08_2023),[V883,V884,V885]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V882) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a15,policy1) +| | | Call: claim.hospital(claim_a15,V886) +| | | Exit: claim.hospital(claim_a15,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a15,V887) +| | | Exit: claim.reason(claim_a15,preventive_care) +| | | Call: eligible_service(claim_a15,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a15,preventive_care) +| | | | | Call: claim.claimant(claim_a15,V888) +| | | | | Exit: claim.claimant(claim_a15,person_a15) +| | | | | Call: person.dob(person_a15,V889) +| | | | | Exit: person.dob(person_a15,04_02_2023) +| | | | | Call: claim.time(claim_a15,V890,V891) +| | | | | Fail: claim.time(claim_a15,V890,V891) +| | | | | Redo: person.dob(person_a15,V889) +| | | | | Fail: person.dob(person_a15,V889) +| | | | | Redo: claim.claimant(claim_a15,V888) +| | | | | Fail: claim.claimant(claim_a15,V888) +| | | | Fail: check_policy_year_limit(claim_a15,preventive_care) +| | | | Call: covered_list_with_location(V892) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V892) +| | | | Fail: covered_list_with_location(V892) +| | | | Call: covered_list_with_service_provider(V893) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V893) +| | | | Fail: covered_list_with_service_provider(V893) +| | | | Call: covered_list(V894) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V894) +| | | | Fail: covered_list(V894) +| | | | Call: claim.location(claim_a15,V895) +| | | | Exit: claim.location(claim_a15,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a15,hep_b) +| | | | Fail: claim.vaccine(claim_a15,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a15,V895) +| | | | Fail: claim.location(claim_a15,V895) +| | | | Call: claim.location(claim_a15,V896) +| | | | Exit: claim.location(claim_a15,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a15,covid) +| | | | Fail: claim.vaccine(claim_a15,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a15,V896) +| | | | Fail: claim.location(claim_a15,V896) +| | | | Call: claim.location(claim_a15,V897) +| | | | Exit: claim.location(claim_a15,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a15,flu) +| | | | Exit: claim.vaccine(claim_a15,flu) +| | | | Call: claim.claimant(claim_a15,V898) +| | | | Exit: claim.claimant(claim_a15,person_a15) +| | | | Call: person.dob(person_a15,V899) +| | | | Exit: person.dob(person_a15,04_02_2023) +| | | | Call: claim.hosp_start_time(claim_a15,V900,V901) +| | | | Exit: claim.hosp_start_time(claim_a15,03_09_2023,00_00) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2023,V902) +| | | | | Call: evaluate(parsedate(03_09_2023),[V903,V904,V905]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V906,V907,V908]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V909) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V910) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V911) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),7),V912) +| | | | | Exit: evaluate(plus(imul(12,0),7),7) +| | | | | Call: evaluate(if(leq(-1,-1),minus(7,1),true,7),V902) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(7,1),true,7),6) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: claim.previous_vaccines_flu_more_than_equal_2(claim_a15,V913) +| | | | Exit: claim.previous_vaccines_flu_more_than_equal_2(claim_a15,yes) +| | | | Call: age_range_limit_flu(claim_a15,V914,V915,V916,yes) +| | | | Exit: age_range_limit_flu(C,1,0,20000,PC) +| | | | Call: leq(0,6) +| | | | Exit: leq(0,6) +| | | | Call: leq(6,20000) +| | | | Exit: leq(6,20000) +| | | | Call: claim.vaccine_dose_count_annual(claim_a15,V917) +| | | | Exit: claim.vaccine_dose_count_annual(claim_a15,2) +| | | | Call: leq(2,1) +| | | | Fail: leq(2,1) +| | | | Redo: claim.vaccine_dose_count_annual(claim_a15,V917) +| | | | Fail: claim.vaccine_dose_count_annual(claim_a15,V917) +| | | | Redo: age_range_limit_flu(claim_a15,V914,V915,V916,yes) +| | | | Fail: age_range_limit_flu(claim_a15,V914,V915,V916,yes) +| | | | Redo: claim.previous_vaccines_flu_more_than_equal_2(claim_a15,V913) +| | | | Fail: claim.previous_vaccines_flu_more_than_equal_2(claim_a15,V913) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2023,V902) +| | | | Redo: claim.hosp_start_time(claim_a15,V900,V901) +| | | | Fail: claim.hosp_start_time(claim_a15,V900,V901) +| | | | Redo: person.dob(person_a15,V899) +| | | | Fail: person.dob(person_a15,V899) +| | | | Redo: claim.claimant(claim_a15,V898) +| | | | Fail: claim.claimant(claim_a15,V898) +| | | | Redo: claim.vaccine(claim_a15,flu) +| | | | Fail: claim.vaccine(claim_a15,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a15,V897) +| | | | Fail: claim.location(claim_a15,V897) +| | | Fail: eligible_service(claim_a15,policy1,preventive_care) +| | | Redo: claim.reason(claim_a15,V887) +| | | Fail: claim.reason(claim_a15,V887) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a15,V886) +| | | Fail: claim.hospital(claim_a15,V886) +| | | Call: claim.reason(claim_a15,emergency_room) +| | | Fail: claim.reason(claim_a15,emergency_room) +| | Fail: valid_hospitalization(claim_a15,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V882) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V878) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V874) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V870) +| | | Redo: policy.enddate(policy1,person_a15,V869) +| | | Fail: policy.enddate(policy1,person_a15,V869) +| | | Redo: policy.startdate(policy1,person_a15,V868) +| | | Fail: policy.startdate(policy1,person_a15,V868) +| | | Redo: claim.hosp_end_time(claim_a15,V866,V867) +| | | Fail: claim.hosp_end_time(claim_a15,V866,V867) +| | | Redo: claim.hosp_start_time(claim_a15,V864,V865) +| | | Fail: claim.hosp_start_time(claim_a15,V864,V865) +| | | Redo: claim.claimant(claim_a15,V863) +| | | Fail: claim.claimant(claim_a15,V863) +| | Fail: policy_active(claim_a15,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a15) +| | | Fail: policy.insuree(policy1,person_a15) +| | | Redo: claim.claimant(claim_a15,V862) +| | | Fail: claim.claimant(claim_a15,V862) +| | Fail: valid_insuree(claim_a15,policy1) +| Fail: covered_under_policy(claim_a15,policy1,cardinal) +| Redo: policy.type(policy1,V804) +| Fail: policy.type(policy1,V804) +| Redo: claim.policy(X,V803) +| Exit: claim.policy(claim_a16,policy1) +| Call: policy.type(policy1,V804) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a16,policy1,cardinal) +| | Call: valid_insuree(claim_a16,policy1) +| | | Call: claim.claimant(claim_a16,V918) +| | | Exit: claim.claimant(claim_a16,person_a16) +| | | Call: policy.insuree(policy1,person_a16) +| | | Exit: policy.insuree(policy1,person_a16) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a16,policy1) +| | | Call: claim.claimant(claim_a16,V919) +| | | Exit: claim.claimant(claim_a16,person_a16) +| | | Call: claim.hosp_start_time(claim_a16,V920,V921) +| | | Exit: claim.hosp_start_time(claim_a16,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a16,V922,V923) +| | | Exit: claim.hosp_end_time(claim_a16,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a16,V924) +| | | Exit: policy.startdate(policy1,person_a16,01_08_2023) +| | | Call: policy.enddate(policy1,person_a16,V925) +| | | Exit: policy.enddate(policy1,person_a16,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V926) +| | | | Call: evaluate(parsedate(03_09_2023),[V927,V928,V929]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V926) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V930) +| | | | Call: evaluate(parsedate(03_09_2023),[V931,V932,V933]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V930) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V934) +| | | | Call: evaluate(parsedate(30_06_2024),[V935,V936,V937]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V934) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V938) +| | | | Call: evaluate(parsedate(01_08_2023),[V939,V940,V941]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V938) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a16,policy1) +| | | Call: claim.hospital(claim_a16,V942) +| | | Exit: claim.hospital(claim_a16,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a16,V943) +| | | Exit: claim.reason(claim_a16,preventive_care) +| | | Call: eligible_service(claim_a16,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a16,preventive_care) +| | | | | Call: claim.claimant(claim_a16,V944) +| | | | | Exit: claim.claimant(claim_a16,person_a16) +| | | | | Call: person.dob(person_a16,V945) +| | | | | Exit: person.dob(person_a16,04_02_2001) +| | | | | Call: claim.time(claim_a16,V946,V947) +| | | | | Fail: claim.time(claim_a16,V946,V947) +| | | | | Redo: person.dob(person_a16,V945) +| | | | | Fail: person.dob(person_a16,V945) +| | | | | Redo: claim.claimant(claim_a16,V944) +| | | | | Fail: claim.claimant(claim_a16,V944) +| | | | Fail: check_policy_year_limit(claim_a16,preventive_care) +| | | | Call: covered_list_with_location(V948) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V948) +| | | | Fail: covered_list_with_location(V948) +| | | | Call: covered_list_with_service_provider(V949) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V949) +| | | | Fail: covered_list_with_service_provider(V949) +| | | | Call: covered_list(V950) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V950) +| | | | Fail: covered_list(V950) +| | | | Call: claim.location(claim_a16,V951) +| | | | Exit: claim.location(claim_a16,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a16,hep_b) +| | | | Fail: claim.vaccine(claim_a16,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a16,V951) +| | | | Fail: claim.location(claim_a16,V951) +| | | | Call: claim.location(claim_a16,V952) +| | | | Exit: claim.location(claim_a16,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a16,covid) +| | | | Fail: claim.vaccine(claim_a16,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a16,V952) +| | | | Fail: claim.location(claim_a16,V952) +| | | | Call: claim.location(claim_a16,V953) +| | | | Exit: claim.location(claim_a16,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a16,flu) +| | | | Exit: claim.vaccine(claim_a16,flu) +| | | | Call: claim.claimant(claim_a16,V954) +| | | | Exit: claim.claimant(claim_a16,person_a16) +| | | | Call: person.dob(person_a16,V955) +| | | | Exit: person.dob(person_a16,04_02_2001) +| | | | Call: claim.hosp_start_time(claim_a16,V956,V957) +| | | | Exit: claim.hosp_start_time(claim_a16,03_09_2023,00_00) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2001,V958) +| | | | | Call: evaluate(parsedate(03_09_2023),[V959,V960,V961]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2001),[V962,V963,V964]) +| | | | | Exit: evaluate(parsedate(04_02_2001),[04,02,2001]) +| | | | | Call: evaluate(minus(2023,2001),V965) +| | | | | Exit: evaluate(minus(2023,2001),22) +| | | | | Call: evaluate(minus(09,02),V966) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V967) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,22),7),V968) +| | | | | Exit: evaluate(plus(imul(12,22),7),271) +| | | | | Call: evaluate(if(leq(-1,-1),minus(271,1),true,271),V958) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(271,1),true,271),270) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: claim.previous_vaccines_flu_more_than_equal_2(claim_a16,V969) +| | | | Exit: claim.previous_vaccines_flu_more_than_equal_2(claim_a16,yes) +| | | | Call: age_range_limit_flu(claim_a16,V970,V971,V972,yes) +| | | | Exit: age_range_limit_flu(C,1,0,20000,PC) +| | | | Call: leq(0,270) +| | | | Exit: leq(0,270) +| | | | Call: leq(270,20000) +| | | | Exit: leq(270,20000) +| | | | Call: claim.vaccine_dose_count_annual(claim_a16,V973) +| | | | Exit: claim.vaccine_dose_count_annual(claim_a16,2) +| | | | Call: leq(2,1) +| | | | Fail: leq(2,1) +| | | | Redo: claim.vaccine_dose_count_annual(claim_a16,V973) +| | | | Fail: claim.vaccine_dose_count_annual(claim_a16,V973) +| | | | Redo: age_range_limit_flu(claim_a16,V970,V971,V972,yes) +| | | | Fail: age_range_limit_flu(claim_a16,V970,V971,V972,yes) +| | | | Redo: claim.previous_vaccines_flu_more_than_equal_2(claim_a16,V969) +| | | | Fail: claim.previous_vaccines_flu_more_than_equal_2(claim_a16,V969) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2001,V958) +| | | | Redo: claim.hosp_start_time(claim_a16,V956,V957) +| | | | Fail: claim.hosp_start_time(claim_a16,V956,V957) +| | | | Redo: person.dob(person_a16,V955) +| | | | Fail: person.dob(person_a16,V955) +| | | | Redo: claim.claimant(claim_a16,V954) +| | | | Fail: claim.claimant(claim_a16,V954) +| | | | Redo: claim.vaccine(claim_a16,flu) +| | | | Fail: claim.vaccine(claim_a16,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a16,V953) +| | | | Fail: claim.location(claim_a16,V953) +| | | Fail: eligible_service(claim_a16,policy1,preventive_care) +| | | Redo: claim.reason(claim_a16,V943) +| | | Fail: claim.reason(claim_a16,V943) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a16,V942) +| | | Fail: claim.hospital(claim_a16,V942) +| | | Call: claim.reason(claim_a16,emergency_room) +| | | Fail: claim.reason(claim_a16,emergency_room) +| | Fail: valid_hospitalization(claim_a16,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V938) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V934) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V930) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V926) +| | | Redo: policy.enddate(policy1,person_a16,V925) +| | | Fail: policy.enddate(policy1,person_a16,V925) +| | | Redo: policy.startdate(policy1,person_a16,V924) +| | | Fail: policy.startdate(policy1,person_a16,V924) +| | | Redo: claim.hosp_end_time(claim_a16,V922,V923) +| | | Fail: claim.hosp_end_time(claim_a16,V922,V923) +| | | Redo: claim.hosp_start_time(claim_a16,V920,V921) +| | | Fail: claim.hosp_start_time(claim_a16,V920,V921) +| | | Redo: claim.claimant(claim_a16,V919) +| | | Fail: claim.claimant(claim_a16,V919) +| | Fail: policy_active(claim_a16,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a16) +| | | Fail: policy.insuree(policy1,person_a16) +| | | Redo: claim.claimant(claim_a16,V918) +| | | Fail: claim.claimant(claim_a16,V918) +| | Fail: valid_insuree(claim_a16,policy1) +| Fail: covered_under_policy(claim_a16,policy1,cardinal) +| Redo: policy.type(policy1,V804) +| Fail: policy.type(policy1,V804) +| Redo: claim.policy(X,V803) +| Exit: claim.policy(claim_a17,policy1) +| Call: policy.type(policy1,V804) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a17,policy1,cardinal) +| | Call: valid_insuree(claim_a17,policy1) +| | | Call: claim.claimant(claim_a17,V974) +| | | Exit: claim.claimant(claim_a17,person_a17) +| | | Call: policy.insuree(policy1,person_a17) +| | | Exit: policy.insuree(policy1,person_a17) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a17,policy1) +| | | Call: claim.claimant(claim_a17,V975) +| | | Exit: claim.claimant(claim_a17,person_a17) +| | | Call: claim.hosp_start_time(claim_a17,V976,V977) +| | | Exit: claim.hosp_start_time(claim_a17,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a17,V978,V979) +| | | Exit: claim.hosp_end_time(claim_a17,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a17,V980) +| | | Exit: policy.startdate(policy1,person_a17,01_08_2023) +| | | Call: policy.enddate(policy1,person_a17,V981) +| | | Exit: policy.enddate(policy1,person_a17,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V982) +| | | | Call: evaluate(parsedate(03_09_2023),[V983,V984,V985]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V982) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V986) +| | | | Call: evaluate(parsedate(03_09_2023),[V987,V988,V989]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V986) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V990) +| | | | Call: evaluate(parsedate(30_06_2024),[V991,V992,V993]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V990) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V994) +| | | | Call: evaluate(parsedate(01_08_2023),[V995,V996,V997]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V994) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a17,policy1) +| | | Call: claim.hospital(claim_a17,V998) +| | | Exit: claim.hospital(claim_a17,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a17,V999) +| | | Exit: claim.reason(claim_a17,preventive_care) +| | | Call: eligible_service(claim_a17,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a17,preventive_care) +| | | | | Call: claim.claimant(claim_a17,V1000) +| | | | | Exit: claim.claimant(claim_a17,person_a17) +| | | | | Call: person.dob(person_a17,V1001) +| | | | | Exit: person.dob(person_a17,04_02_2023) +| | | | | Call: claim.time(claim_a17,V1002,V1003) +| | | | | Fail: claim.time(claim_a17,V1002,V1003) +| | | | | Redo: person.dob(person_a17,V1001) +| | | | | Fail: person.dob(person_a17,V1001) +| | | | | Redo: claim.claimant(claim_a17,V1000) +| | | | | Fail: claim.claimant(claim_a17,V1000) +| | | | Fail: check_policy_year_limit(claim_a17,preventive_care) +| | | | Call: covered_list_with_location(V1004) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1004) +| | | | Fail: covered_list_with_location(V1004) +| | | | Call: covered_list_with_service_provider(V1005) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1005) +| | | | Fail: covered_list_with_service_provider(V1005) +| | | | Call: covered_list(V1006) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1006) +| | | | Fail: covered_list(V1006) +| | | | Call: claim.location(claim_a17,V1007) +| | | | Exit: claim.location(claim_a17,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a17,hep_b) +| | | | Fail: claim.vaccine(claim_a17,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a17,V1007) +| | | | Fail: claim.location(claim_a17,V1007) +| | | | Call: claim.location(claim_a17,V1008) +| | | | Exit: claim.location(claim_a17,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a17,covid) +| | | | Fail: claim.vaccine(claim_a17,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a17,V1008) +| | | | Fail: claim.location(claim_a17,V1008) +| | | | Call: claim.location(claim_a17,V1009) +| | | | Exit: claim.location(claim_a17,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a17,flu) +| | | | Exit: claim.vaccine(claim_a17,flu) +| | | | Call: claim.claimant(claim_a17,V1010) +| | | | Exit: claim.claimant(claim_a17,person_a17) +| | | | Call: person.dob(person_a17,V1011) +| | | | Exit: person.dob(person_a17,04_02_2023) +| | | | Call: claim.hosp_start_time(claim_a17,V1012,V1013) +| | | | Exit: claim.hosp_start_time(claim_a17,03_09_2023,00_00) +| | | | Call: get_date_diff_in_months(03_09_2023,04_02_2023,V1014) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1015,V1016,V1017]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_02_2023),[V1018,V1019,V1020]) +| | | | | Exit: evaluate(parsedate(04_02_2023),[04,02,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1021) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,02),V1022) +| | | | | Exit: evaluate(minus(09,02),7) +| | | | | Call: evaluate(minus(03,04),V1023) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),7),V1024) +| | | | | Exit: evaluate(plus(imul(12,0),7),7) +| | | | | Call: evaluate(if(leq(-1,-1),minus(7,1),true,7),V1014) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(7,1),true,7),6) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: claim.previous_vaccines_flu_more_than_equal_2(claim_a17,V1025) +| | | | Exit: claim.previous_vaccines_flu_more_than_equal_2(claim_a17,yes) +| | | | Call: age_range_limit_flu(claim_a17,V1026,V1027,V1028,yes) +| | | | Exit: age_range_limit_flu(C,1,0,20000,PC) +| | | | Call: leq(0,6) +| | | | Exit: leq(0,6) +| | | | Call: leq(6,20000) +| | | | Exit: leq(6,20000) +| | | | Call: claim.vaccine_dose_count_annual(claim_a17,V1029) +| | | | Exit: claim.vaccine_dose_count_annual(claim_a17,1) +| | | | Call: leq(1,1) +| | | | Exit: leq(1,1) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a17,policy1) +Call: exception(claim_a17,policy1) +| Call: claim.claimant(claim_a17,V1030) +| Exit: claim.claimant(claim_a17,person_a17) +| Call: person.occupation(person_a17,armed_forces) +| Fail: person.occupation(person_a17,armed_forces) +| Redo: claim.claimant(claim_a17,V1030) +| Fail: claim.claimant(claim_a17,V1030) +| Call: claim.reason(claim_a17,home_health_care) +| Fail: claim.reason(claim_a17,home_health_care) +| Call: claim.reason(claim_a17,home_health_care) +| Fail: claim.reason(claim_a17,home_health_care) +Fail: exception(claim_a17,policy1) +| | | Exit: ~exception(claim_a17,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a17) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: claim.vaccine_dose_count_annual(claim_a17,V1029) +| | | | Fail: claim.vaccine_dose_count_annual(claim_a17,V1029) +| | | | Redo: age_range_limit_flu(claim_a17,V1026,V1027,V1028,yes) +| | | | Fail: age_range_limit_flu(claim_a17,V1026,V1027,V1028,yes) +| | | | Redo: claim.previous_vaccines_flu_more_than_equal_2(claim_a17,V1025) +| | | | Fail: claim.previous_vaccines_flu_more_than_equal_2(claim_a17,V1025) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_02_2023,V1014) +| | | | Redo: claim.hosp_start_time(claim_a17,V1012,V1013) +| | | | Fail: claim.hosp_start_time(claim_a17,V1012,V1013) +| | | | Redo: person.dob(person_a17,V1011) +| | | | Fail: person.dob(person_a17,V1011) +| | | | Redo: claim.claimant(claim_a17,V1010) +| | | | Fail: claim.claimant(claim_a17,V1010) +| | | | Redo: claim.vaccine(claim_a17,flu) +| | | | Fail: claim.vaccine(claim_a17,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a17,V1009) +| | | | Fail: claim.location(claim_a17,V1009) +| | | Fail: eligible_service(claim_a17,policy1,preventive_care) +| | | Redo: claim.reason(claim_a17,V999) +| | | Fail: claim.reason(claim_a17,V999) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a17,V998) +| | | Fail: claim.hospital(claim_a17,V998) +| | | Call: claim.reason(claim_a17,emergency_room) +| | | Fail: claim.reason(claim_a17,emergency_room) +| | Fail: valid_hospitalization(claim_a17,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V994) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V990) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V986) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V982) +| | | Redo: policy.enddate(policy1,person_a17,V981) +| | | Fail: policy.enddate(policy1,person_a17,V981) +| | | Redo: policy.startdate(policy1,person_a17,V980) +| | | Fail: policy.startdate(policy1,person_a17,V980) +| | | Redo: claim.hosp_end_time(claim_a17,V978,V979) +| | | Fail: claim.hosp_end_time(claim_a17,V978,V979) +| | | Redo: claim.hosp_start_time(claim_a17,V976,V977) +| | | Fail: claim.hosp_start_time(claim_a17,V976,V977) +| | | Redo: claim.claimant(claim_a17,V975) +| | | Fail: claim.claimant(claim_a17,V975) +| | Fail: policy_active(claim_a17,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a17) +| | | Fail: policy.insuree(policy1,person_a17) +| | | Redo: claim.claimant(claim_a17,V974) +| | | Fail: claim.claimant(claim_a17,V974) +| | Fail: valid_insuree(claim_a17,policy1) +| Fail: covered_under_policy(claim_a17,policy1,cardinal) +| Redo: policy.type(policy1,V804) +| Fail: policy.type(policy1,V804) +| Redo: claim.policy(X,V803) +| Fail: claim.policy(X,V803) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_flu.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim_a14', 'claim_a17' ] +RESULTS: [ 'claim_a14', 'claim_a17' ] +===== TEST SUCCEEDED: Test test_cases_flu.hdf===== +Expected Result: [ 'claim_a4', 'claim_a6' ] +Call: covered(X) +| Call: claim.policy(X,V1031) +| Exit: claim.policy(claim_a4,policy1) +| Call: policy.type(policy1,V1032) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a4,policy1,cardinal) +| | Call: valid_insuree(claim_a4,policy1) +| | | Call: claim.claimant(claim_a4,V1033) +| | | Exit: claim.claimant(claim_a4,person_a4) +| | | Call: policy.insuree(policy1,person_a4) +| | | Exit: policy.insuree(policy1,person_a4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a4,policy1) +| | | Call: claim.claimant(claim_a4,V1034) +| | | Exit: claim.claimant(claim_a4,person_a4) +| | | Call: claim.hosp_start_time(claim_a4,V1035,V1036) +| | | Exit: claim.hosp_start_time(claim_a4,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a4,V1037,V1038) +| | | Exit: claim.hosp_end_time(claim_a4,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a4,V1039) +| | | Exit: policy.startdate(policy1,person_a4,01_08_2023) +| | | Call: policy.enddate(policy1,person_a4,V1040) +| | | Exit: policy.enddate(policy1,person_a4,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V1041) +| | | | Call: evaluate(parsedate(03_09_2023),[V1042,V1043,V1044]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1041) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V1045) +| | | | Call: evaluate(parsedate(03_09_2023),[V1046,V1047,V1048]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1045) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1049) +| | | | Call: evaluate(parsedate(30_06_2024),[V1050,V1051,V1052]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1049) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1053) +| | | | Call: evaluate(parsedate(01_08_2023),[V1054,V1055,V1056]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1053) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a4,policy1) +| | | Call: claim.hospital(claim_a4,V1057) +| | | Exit: claim.hospital(claim_a4,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a4,V1058) +| | | Exit: claim.reason(claim_a4,preventive_care) +| | | Call: eligible_service(claim_a4,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a4,preventive_care) +| | | | | Call: claim.claimant(claim_a4,V1059) +| | | | | Exit: claim.claimant(claim_a4,person_a4) +| | | | | Call: person.dob(person_a4,V1060) +| | | | | Exit: person.dob(person_a4,04_08_2023) +| | | | | Call: claim.time(claim_a4,V1061,V1062) +| | | | | Fail: claim.time(claim_a4,V1061,V1062) +| | | | | Redo: person.dob(person_a4,V1060) +| | | | | Fail: person.dob(person_a4,V1060) +| | | | | Redo: claim.claimant(claim_a4,V1059) +| | | | | Fail: claim.claimant(claim_a4,V1059) +| | | | Fail: check_policy_year_limit(claim_a4,preventive_care) +| | | | Call: covered_list_with_location(V1063) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1063) +| | | | Fail: covered_list_with_location(V1063) +| | | | Call: covered_list_with_service_provider(V1064) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1064) +| | | | Fail: covered_list_with_service_provider(V1064) +| | | | Call: covered_list(V1065) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1065) +| | | | Fail: covered_list(V1065) +| | | | Call: claim.location(claim_a4,V1066) +| | | | Exit: claim.location(claim_a4,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a4,hep_b) +| | | | Exit: claim.vaccine(claim_a4,hep_b) +| | | | Call: claim.claimant(claim_a4,V1067) +| | | | Exit: claim.claimant(claim_a4,person_a4) +| | | | Call: person.dob(person_a4,V1068) +| | | | Exit: person.dob(person_a4,04_08_2023) +| | | | Call: claim.hosp_start_time(claim_a4,V1069,V1070) +| | | | Exit: claim.hosp_start_time(claim_a4,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_08_2023,V1071) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1072,V1073,V1074]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1075,V1076,V1077]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1078) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1079) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1080) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,1),-1),V1081) +| | | | | Exit: evaluate(plus(imul(31,1),-1),30) +| | | | | Call: evaluate(plus(0,if(leq(30,-1),-1,true,0)),V1071) +| | | | | Exit: evaluate(plus(0,if(leq(30,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_08_2023,V1082) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1083,V1084,V1085]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1086,V1087,V1088]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1089) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1090) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1091) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),1),V1092) +| | | | | Exit: evaluate(plus(imul(12,0),1),1) +| | | | | Call: evaluate(if(leq(-1,-1),minus(1,1),true,1),V1082) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(1,1),true,1),0) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: age_range_limit_hepb(claim_a4,V1093,0,0) +| | | | Exit: age_range_limit_hepb(C,1,Y,0) +| | | | Call: claim.vaccine_dose_count(claim_a4,V1094) +| | | | Exit: claim.vaccine_dose_count(claim_a4,1) +| | | | Call: leq(1,1) +| | | | Exit: leq(1,1) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a4,policy1) +Call: exception(claim_a4,policy1) +| Call: claim.claimant(claim_a4,V1095) +| Exit: claim.claimant(claim_a4,person_a4) +| Call: person.occupation(person_a4,armed_forces) +| Fail: person.occupation(person_a4,armed_forces) +| Redo: claim.claimant(claim_a4,V1095) +| Fail: claim.claimant(claim_a4,V1095) +| Call: claim.reason(claim_a4,home_health_care) +| Fail: claim.reason(claim_a4,home_health_care) +| Call: claim.reason(claim_a4,home_health_care) +| Fail: claim.reason(claim_a4,home_health_care) +Fail: exception(claim_a4,policy1) +| | | Exit: ~exception(claim_a4,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a4) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: claim.vaccine_dose_count(claim_a4,V1094) +| | | | Fail: claim.vaccine_dose_count(claim_a4,V1094) +| | | | Redo: age_range_limit_hepb(claim_a4,V1093,0,0) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(6,0) +| | | | | Fail: leq(6,0) +| | | | | Call: leq(19,0) +| | | | | Fail: leq(19,0) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: mother_hbsag_positive_unknown(claim_a4) +| | | | | | Call: claim.mother_hbsag(claim_a4,positive) +| | | | | | Fail: claim.mother_hbsag(claim_a4,positive) +| | | | | | Call: claim.mother_hbsag(V1096,unknown) +| | | | | | Fail: claim.mother_hbsag(V1096,unknown) +| | | | | Fail: mother_hbsag_positive_unknown(claim_a4) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: claim.birth_weight(claim_a4,V1097) +| | | | | Fail: claim.birth_weight(claim_a4,V1097) +| | | | | Call: claim.claimant(claim_a4,V1098) +| | | | | Exit: claim.claimant(claim_a4,person_a4) +| | | | | Call: eligible_for_revaccination(person_a4) +| | | | | | Call: person.occupation(person_a4,healthcare_worker) +| | | | | | Fail: person.occupation(person_a4,healthcare_worker) +| | | | | | Call: person.condition(person_a4,immunocompromised) +| | | | | | Fail: person.condition(person_a4,immunocompromised) +| | | | | | Call: person.condition(person_a4,hemodialysis_patient) +| | | | | | Fail: person.condition(person_a4,hemodialysis_patient) +| | | | | Fail: eligible_for_revaccination(person_a4) +| | | | | Redo: claim.claimant(claim_a4,V1098) +| | | | | Fail: claim.claimant(claim_a4,V1098) +| | | | Fail: age_range_limit_hepb(claim_a4,V1093,0,0) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_08_2023,V1082) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_08_2023,V1071) +| | | | Redo: claim.hosp_start_time(claim_a4,V1069,V1070) +| | | | Fail: claim.hosp_start_time(claim_a4,V1069,V1070) +| | | | Redo: person.dob(person_a4,V1068) +| | | | Fail: person.dob(person_a4,V1068) +| | | | Redo: claim.claimant(claim_a4,V1067) +| | | | Fail: claim.claimant(claim_a4,V1067) +| | | | Redo: claim.vaccine(claim_a4,hep_b) +| | | | Fail: claim.vaccine(claim_a4,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a4,V1066) +| | | | Fail: claim.location(claim_a4,V1066) +| | | | Call: claim.location(claim_a4,V1099) +| | | | Exit: claim.location(claim_a4,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a4,covid) +| | | | Fail: claim.vaccine(claim_a4,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a4,V1099) +| | | | Fail: claim.location(claim_a4,V1099) +| | | | Call: claim.location(claim_a4,V1100) +| | | | Exit: claim.location(claim_a4,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a4,flu) +| | | | Fail: claim.vaccine(claim_a4,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a4,V1100) +| | | | Fail: claim.location(claim_a4,V1100) +| | | Fail: eligible_service(claim_a4,policy1,preventive_care) +| | | Redo: claim.reason(claim_a4,V1058) +| | | Fail: claim.reason(claim_a4,V1058) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a4,V1057) +| | | Fail: claim.hospital(claim_a4,V1057) +| | | Call: claim.reason(claim_a4,emergency_room) +| | | Fail: claim.reason(claim_a4,emergency_room) +| | Fail: valid_hospitalization(claim_a4,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1053) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1049) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1045) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1041) +| | | Redo: policy.enddate(policy1,person_a4,V1040) +| | | Fail: policy.enddate(policy1,person_a4,V1040) +| | | Redo: policy.startdate(policy1,person_a4,V1039) +| | | Fail: policy.startdate(policy1,person_a4,V1039) +| | | Redo: claim.hosp_end_time(claim_a4,V1037,V1038) +| | | Fail: claim.hosp_end_time(claim_a4,V1037,V1038) +| | | Redo: claim.hosp_start_time(claim_a4,V1035,V1036) +| | | Fail: claim.hosp_start_time(claim_a4,V1035,V1036) +| | | Redo: claim.claimant(claim_a4,V1034) +| | | Fail: claim.claimant(claim_a4,V1034) +| | Fail: policy_active(claim_a4,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a4) +| | | Fail: policy.insuree(policy1,person_a4) +| | | Redo: claim.claimant(claim_a4,V1033) +| | | Fail: claim.claimant(claim_a4,V1033) +| | Fail: valid_insuree(claim_a4,policy1) +| Fail: covered_under_policy(claim_a4,policy1,cardinal) +| Redo: policy.type(policy1,V1032) +| Fail: policy.type(policy1,V1032) +| Redo: claim.policy(X,V1031) +| Exit: claim.policy(claim_a5,policy1) +| Call: policy.type(policy1,V1032) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a5,policy1,cardinal) +| | Call: valid_insuree(claim_a5,policy1) +| | | Call: claim.claimant(claim_a5,V1101) +| | | Exit: claim.claimant(claim_a5,person_a5) +| | | Call: policy.insuree(policy1,person_a5) +| | | Exit: policy.insuree(policy1,person_a5) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a5,policy1) +| | | Call: claim.claimant(claim_a5,V1102) +| | | Exit: claim.claimant(claim_a5,person_a5) +| | | Call: claim.hosp_start_time(claim_a5,V1103,V1104) +| | | Exit: claim.hosp_start_time(claim_a5,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a5,V1105,V1106) +| | | Exit: claim.hosp_end_time(claim_a5,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a5,V1107) +| | | Exit: policy.startdate(policy1,person_a5,01_08_2023) +| | | Call: policy.enddate(policy1,person_a5,V1108) +| | | Exit: policy.enddate(policy1,person_a5,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V1109) +| | | | Call: evaluate(parsedate(03_09_2023),[V1110,V1111,V1112]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1109) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V1113) +| | | | Call: evaluate(parsedate(03_09_2023),[V1114,V1115,V1116]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1113) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1117) +| | | | Call: evaluate(parsedate(30_06_2024),[V1118,V1119,V1120]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1117) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1121) +| | | | Call: evaluate(parsedate(01_08_2023),[V1122,V1123,V1124]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1121) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a5,policy1) +| | | Call: claim.hospital(claim_a5,V1125) +| | | Exit: claim.hospital(claim_a5,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a5,V1126) +| | | Exit: claim.reason(claim_a5,preventive_care) +| | | Call: eligible_service(claim_a5,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a5,preventive_care) +| | | | | Call: claim.claimant(claim_a5,V1127) +| | | | | Exit: claim.claimant(claim_a5,person_a5) +| | | | | Call: person.dob(person_a5,V1128) +| | | | | Exit: person.dob(person_a5,04_08_2023) +| | | | | Call: claim.time(claim_a5,V1129,V1130) +| | | | | Fail: claim.time(claim_a5,V1129,V1130) +| | | | | Redo: person.dob(person_a5,V1128) +| | | | | Fail: person.dob(person_a5,V1128) +| | | | | Redo: claim.claimant(claim_a5,V1127) +| | | | | Fail: claim.claimant(claim_a5,V1127) +| | | | Fail: check_policy_year_limit(claim_a5,preventive_care) +| | | | Call: covered_list_with_location(V1131) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1131) +| | | | Fail: covered_list_with_location(V1131) +| | | | Call: covered_list_with_service_provider(V1132) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1132) +| | | | Fail: covered_list_with_service_provider(V1132) +| | | | Call: covered_list(V1133) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1133) +| | | | Fail: covered_list(V1133) +| | | | Call: claim.location(claim_a5,V1134) +| | | | Exit: claim.location(claim_a5,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a5,hep_b) +| | | | Exit: claim.vaccine(claim_a5,hep_b) +| | | | Call: claim.claimant(claim_a5,V1135) +| | | | Exit: claim.claimant(claim_a5,person_a5) +| | | | Call: person.dob(person_a5,V1136) +| | | | Exit: person.dob(person_a5,04_08_2023) +| | | | Call: claim.hosp_start_time(claim_a5,V1137,V1138) +| | | | Exit: claim.hosp_start_time(claim_a5,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_08_2023,V1139) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1140,V1141,V1142]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1143,V1144,V1145]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1146) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1147) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1148) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,1),-1),V1149) +| | | | | Exit: evaluate(plus(imul(31,1),-1),30) +| | | | | Call: evaluate(plus(0,if(leq(30,-1),-1,true,0)),V1139) +| | | | | Exit: evaluate(plus(0,if(leq(30,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_08_2023,V1150) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1151,V1152,V1153]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1154,V1155,V1156]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1157) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1158) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1159) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),1),V1160) +| | | | | Exit: evaluate(plus(imul(12,0),1),1) +| | | | | Call: evaluate(if(leq(-1,-1),minus(1,1),true,1),V1150) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(1,1),true,1),0) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: age_range_limit_hepb(claim_a5,V1161,0,0) +| | | | Exit: age_range_limit_hepb(C,1,Y,0) +| | | | Call: claim.vaccine_dose_count(claim_a5,V1162) +| | | | Exit: claim.vaccine_dose_count(claim_a5,2) +| | | | Call: leq(2,1) +| | | | Fail: leq(2,1) +| | | | Redo: claim.vaccine_dose_count(claim_a5,V1162) +| | | | Fail: claim.vaccine_dose_count(claim_a5,V1162) +| | | | Redo: age_range_limit_hepb(claim_a5,V1161,0,0) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(6,0) +| | | | | Fail: leq(6,0) +| | | | | Call: leq(19,0) +| | | | | Fail: leq(19,0) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: mother_hbsag_positive_unknown(claim_a5) +| | | | | | Call: claim.mother_hbsag(claim_a5,positive) +| | | | | | Fail: claim.mother_hbsag(claim_a5,positive) +| | | | | | Call: claim.mother_hbsag(V1163,unknown) +| | | | | | Fail: claim.mother_hbsag(V1163,unknown) +| | | | | Fail: mother_hbsag_positive_unknown(claim_a5) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: claim.birth_weight(claim_a5,V1164) +| | | | | Fail: claim.birth_weight(claim_a5,V1164) +| | | | | Call: claim.claimant(claim_a5,V1165) +| | | | | Exit: claim.claimant(claim_a5,person_a5) +| | | | | Call: eligible_for_revaccination(person_a5) +| | | | | | Call: person.occupation(person_a5,healthcare_worker) +| | | | | | Fail: person.occupation(person_a5,healthcare_worker) +| | | | | | Call: person.condition(person_a5,immunocompromised) +| | | | | | Fail: person.condition(person_a5,immunocompromised) +| | | | | | Call: person.condition(person_a5,hemodialysis_patient) +| | | | | | Fail: person.condition(person_a5,hemodialysis_patient) +| | | | | Fail: eligible_for_revaccination(person_a5) +| | | | | Redo: claim.claimant(claim_a5,V1165) +| | | | | Fail: claim.claimant(claim_a5,V1165) +| | | | Fail: age_range_limit_hepb(claim_a5,V1161,0,0) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_08_2023,V1150) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_08_2023,V1139) +| | | | Redo: claim.hosp_start_time(claim_a5,V1137,V1138) +| | | | Fail: claim.hosp_start_time(claim_a5,V1137,V1138) +| | | | Redo: person.dob(person_a5,V1136) +| | | | Fail: person.dob(person_a5,V1136) +| | | | Redo: claim.claimant(claim_a5,V1135) +| | | | Fail: claim.claimant(claim_a5,V1135) +| | | | Redo: claim.vaccine(claim_a5,hep_b) +| | | | Fail: claim.vaccine(claim_a5,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a5,V1134) +| | | | Fail: claim.location(claim_a5,V1134) +| | | | Call: claim.location(claim_a5,V1166) +| | | | Exit: claim.location(claim_a5,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a5,covid) +| | | | Fail: claim.vaccine(claim_a5,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a5,V1166) +| | | | Fail: claim.location(claim_a5,V1166) +| | | | Call: claim.location(claim_a5,V1167) +| | | | Exit: claim.location(claim_a5,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a5,flu) +| | | | Fail: claim.vaccine(claim_a5,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a5,V1167) +| | | | Fail: claim.location(claim_a5,V1167) +| | | Fail: eligible_service(claim_a5,policy1,preventive_care) +| | | Redo: claim.reason(claim_a5,V1126) +| | | Fail: claim.reason(claim_a5,V1126) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a5,V1125) +| | | Fail: claim.hospital(claim_a5,V1125) +| | | Call: claim.reason(claim_a5,emergency_room) +| | | Fail: claim.reason(claim_a5,emergency_room) +| | Fail: valid_hospitalization(claim_a5,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1121) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1117) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1113) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1109) +| | | Redo: policy.enddate(policy1,person_a5,V1108) +| | | Fail: policy.enddate(policy1,person_a5,V1108) +| | | Redo: policy.startdate(policy1,person_a5,V1107) +| | | Fail: policy.startdate(policy1,person_a5,V1107) +| | | Redo: claim.hosp_end_time(claim_a5,V1105,V1106) +| | | Fail: claim.hosp_end_time(claim_a5,V1105,V1106) +| | | Redo: claim.hosp_start_time(claim_a5,V1103,V1104) +| | | Fail: claim.hosp_start_time(claim_a5,V1103,V1104) +| | | Redo: claim.claimant(claim_a5,V1102) +| | | Fail: claim.claimant(claim_a5,V1102) +| | Fail: policy_active(claim_a5,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a5) +| | | Fail: policy.insuree(policy1,person_a5) +| | | Redo: claim.claimant(claim_a5,V1101) +| | | Fail: claim.claimant(claim_a5,V1101) +| | Fail: valid_insuree(claim_a5,policy1) +| Fail: covered_under_policy(claim_a5,policy1,cardinal) +| Redo: policy.type(policy1,V1032) +| Fail: policy.type(policy1,V1032) +| Redo: claim.policy(X,V1031) +| Exit: claim.policy(claim_a6,policy1) +| Call: policy.type(policy1,V1032) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a6,policy1,cardinal) +| | Call: valid_insuree(claim_a6,policy1) +| | | Call: claim.claimant(claim_a6,V1168) +| | | Exit: claim.claimant(claim_a6,person_a6) +| | | Call: policy.insuree(policy1,person_a6) +| | | Exit: policy.insuree(policy1,person_a6) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a6,policy1) +| | | Call: claim.claimant(claim_a6,V1169) +| | | Exit: claim.claimant(claim_a6,person_a6) +| | | Call: claim.hosp_start_time(claim_a6,V1170,V1171) +| | | Exit: claim.hosp_start_time(claim_a6,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a6,V1172,V1173) +| | | Exit: claim.hosp_end_time(claim_a6,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a6,V1174) +| | | Exit: policy.startdate(policy1,person_a6,01_08_2023) +| | | Call: policy.enddate(policy1,person_a6,V1175) +| | | Exit: policy.enddate(policy1,person_a6,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V1176) +| | | | Call: evaluate(parsedate(03_09_2023),[V1177,V1178,V1179]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1176) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V1180) +| | | | Call: evaluate(parsedate(03_09_2023),[V1181,V1182,V1183]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1180) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1184) +| | | | Call: evaluate(parsedate(30_06_2024),[V1185,V1186,V1187]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1184) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1188) +| | | | Call: evaluate(parsedate(01_08_2023),[V1189,V1190,V1191]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1188) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a6,policy1) +| | | Call: claim.hospital(claim_a6,V1192) +| | | Exit: claim.hospital(claim_a6,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a6,V1193) +| | | Exit: claim.reason(claim_a6,preventive_care) +| | | Call: eligible_service(claim_a6,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a6,preventive_care) +| | | | | Call: claim.claimant(claim_a6,V1194) +| | | | | Exit: claim.claimant(claim_a6,person_a6) +| | | | | Call: person.dob(person_a6,V1195) +| | | | | Exit: person.dob(person_a6,04_08_2023) +| | | | | Call: claim.time(claim_a6,V1196,V1197) +| | | | | Fail: claim.time(claim_a6,V1196,V1197) +| | | | | Redo: person.dob(person_a6,V1195) +| | | | | Fail: person.dob(person_a6,V1195) +| | | | | Redo: claim.claimant(claim_a6,V1194) +| | | | | Fail: claim.claimant(claim_a6,V1194) +| | | | Fail: check_policy_year_limit(claim_a6,preventive_care) +| | | | Call: covered_list_with_location(V1198) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1198) +| | | | Fail: covered_list_with_location(V1198) +| | | | Call: covered_list_with_service_provider(V1199) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1199) +| | | | Fail: covered_list_with_service_provider(V1199) +| | | | Call: covered_list(V1200) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1200) +| | | | Fail: covered_list(V1200) +| | | | Call: claim.location(claim_a6,V1201) +| | | | Exit: claim.location(claim_a6,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a6,hep_b) +| | | | Exit: claim.vaccine(claim_a6,hep_b) +| | | | Call: claim.claimant(claim_a6,V1202) +| | | | Exit: claim.claimant(claim_a6,person_a6) +| | | | Call: person.dob(person_a6,V1203) +| | | | Exit: person.dob(person_a6,04_08_2023) +| | | | Call: claim.hosp_start_time(claim_a6,V1204,V1205) +| | | | Exit: claim.hosp_start_time(claim_a6,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_08_2023,V1206) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1207,V1208,V1209]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1210,V1211,V1212]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1213) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1214) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1215) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,1),-1),V1216) +| | | | | Exit: evaluate(plus(imul(31,1),-1),30) +| | | | | Call: evaluate(plus(0,if(leq(30,-1),-1,true,0)),V1206) +| | | | | Exit: evaluate(plus(0,if(leq(30,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_08_2023,V1217) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1218,V1219,V1220]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1221,V1222,V1223]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1224) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1225) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1226) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),1),V1227) +| | | | | Exit: evaluate(plus(imul(12,0),1),1) +| | | | | Call: evaluate(if(leq(-1,-1),minus(1,1),true,1),V1217) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(1,1),true,1),0) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: age_range_limit_hepb(claim_a6,V1228,0,0) +| | | | Exit: age_range_limit_hepb(C,1,Y,0) +| | | | Call: claim.vaccine_dose_count(claim_a6,V1229) +| | | | Exit: claim.vaccine_dose_count(claim_a6,7) +| | | | Call: leq(7,1) +| | | | Fail: leq(7,1) +| | | | Redo: claim.vaccine_dose_count(claim_a6,V1229) +| | | | Fail: claim.vaccine_dose_count(claim_a6,V1229) +| | | | Redo: age_range_limit_hepb(claim_a6,V1228,0,0) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(6,0) +| | | | | Fail: leq(6,0) +| | | | | Call: leq(19,0) +| | | | | Fail: leq(19,0) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: mother_hbsag_positive_unknown(claim_a6) +| | | | | | Call: claim.mother_hbsag(claim_a6,positive) +| | | | | | Fail: claim.mother_hbsag(claim_a6,positive) +| | | | | | Call: claim.mother_hbsag(V1230,unknown) +| | | | | | Fail: claim.mother_hbsag(V1230,unknown) +| | | | | Fail: mother_hbsag_positive_unknown(claim_a6) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: claim.birth_weight(claim_a6,V1231) +| | | | | Exit: claim.birth_weight(claim_a6,1999) +| | | | | Call: leq(1999,2000) +| | | | | Exit: leq(1999,2000) +| | | | | Call: claim.anti_hbs_count(claim_a6,V1232) +| | | | | Exit: claim.anti_hbs_count(claim_a6,9) +| | | | | Call: leq(9,10) +| | | | | Exit: leq(9,10) +| | | | Exit: age_range_limit_hepb(C,N,Y,M) +| | | | Call: claim.vaccine_dose_count(claim_a6,V1229) +| | | | Exit: claim.vaccine_dose_count(claim_a6,7) +| | | | Call: leq(7,7) +| | | | Exit: leq(7,7) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a6,policy1) +Call: exception(claim_a6,policy1) +| Call: claim.claimant(claim_a6,V1233) +| Exit: claim.claimant(claim_a6,person_a6) +| Call: person.occupation(person_a6,armed_forces) +| Fail: person.occupation(person_a6,armed_forces) +| Redo: claim.claimant(claim_a6,V1233) +| Fail: claim.claimant(claim_a6,V1233) +| Call: claim.reason(claim_a6,home_health_care) +| Fail: claim.reason(claim_a6,home_health_care) +| Call: claim.reason(claim_a6,home_health_care) +| Fail: claim.reason(claim_a6,home_health_care) +Fail: exception(claim_a6,policy1) +| | | Exit: ~exception(claim_a6,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a6) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: claim.vaccine_dose_count(claim_a6,V1229) +| | | | Fail: claim.vaccine_dose_count(claim_a6,V1229) +| | | | Redo: age_range_limit_hepb(C,N,Y,M) +| | | | | Redo: claim.anti_hbs_count(claim_a6,V1232) +| | | | | Fail: claim.anti_hbs_count(claim_a6,V1232) +| | | | | Redo: claim.birth_weight(claim_a6,V1231) +| | | | | Fail: claim.birth_weight(claim_a6,V1231) +| | | | | Call: claim.claimant(claim_a6,V1234) +| | | | | Exit: claim.claimant(claim_a6,person_a6) +| | | | | Call: eligible_for_revaccination(person_a6) +| | | | | | Call: person.occupation(person_a6,healthcare_worker) +| | | | | | Fail: person.occupation(person_a6,healthcare_worker) +| | | | | | Call: person.condition(person_a6,immunocompromised) +| | | | | | Fail: person.condition(person_a6,immunocompromised) +| | | | | | Call: person.condition(person_a6,hemodialysis_patient) +| | | | | | Fail: person.condition(person_a6,hemodialysis_patient) +| | | | | Fail: eligible_for_revaccination(person_a6) +| | | | | Redo: claim.claimant(claim_a6,V1234) +| | | | | Fail: claim.claimant(claim_a6,V1234) +| | | | Fail: age_range_limit_hepb(claim_a6,V1228,0,0) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_08_2023,V1217) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_08_2023,V1206) +| | | | Redo: claim.hosp_start_time(claim_a6,V1204,V1205) +| | | | Fail: claim.hosp_start_time(claim_a6,V1204,V1205) +| | | | Redo: person.dob(person_a6,V1203) +| | | | Fail: person.dob(person_a6,V1203) +| | | | Redo: claim.claimant(claim_a6,V1202) +| | | | Fail: claim.claimant(claim_a6,V1202) +| | | | Redo: claim.vaccine(claim_a6,hep_b) +| | | | Fail: claim.vaccine(claim_a6,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a6,V1201) +| | | | Fail: claim.location(claim_a6,V1201) +| | | | Call: claim.location(claim_a6,V1235) +| | | | Exit: claim.location(claim_a6,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a6,covid) +| | | | Fail: claim.vaccine(claim_a6,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a6,V1235) +| | | | Fail: claim.location(claim_a6,V1235) +| | | | Call: claim.location(claim_a6,V1236) +| | | | Exit: claim.location(claim_a6,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a6,flu) +| | | | Fail: claim.vaccine(claim_a6,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a6,V1236) +| | | | Fail: claim.location(claim_a6,V1236) +| | | Fail: eligible_service(claim_a6,policy1,preventive_care) +| | | Redo: claim.reason(claim_a6,V1193) +| | | Fail: claim.reason(claim_a6,V1193) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a6,V1192) +| | | Fail: claim.hospital(claim_a6,V1192) +| | | Call: claim.reason(claim_a6,emergency_room) +| | | Fail: claim.reason(claim_a6,emergency_room) +| | Fail: valid_hospitalization(claim_a6,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1188) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1184) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1180) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1176) +| | | Redo: policy.enddate(policy1,person_a6,V1175) +| | | Fail: policy.enddate(policy1,person_a6,V1175) +| | | Redo: policy.startdate(policy1,person_a6,V1174) +| | | Fail: policy.startdate(policy1,person_a6,V1174) +| | | Redo: claim.hosp_end_time(claim_a6,V1172,V1173) +| | | Fail: claim.hosp_end_time(claim_a6,V1172,V1173) +| | | Redo: claim.hosp_start_time(claim_a6,V1170,V1171) +| | | Fail: claim.hosp_start_time(claim_a6,V1170,V1171) +| | | Redo: claim.claimant(claim_a6,V1169) +| | | Fail: claim.claimant(claim_a6,V1169) +| | Fail: policy_active(claim_a6,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a6) +| | | Fail: policy.insuree(policy1,person_a6) +| | | Redo: claim.claimant(claim_a6,V1168) +| | | Fail: claim.claimant(claim_a6,V1168) +| | Fail: valid_insuree(claim_a6,policy1) +| Fail: covered_under_policy(claim_a6,policy1,cardinal) +| Redo: policy.type(policy1,V1032) +| Fail: policy.type(policy1,V1032) +| Redo: claim.policy(X,V1031) +| Exit: claim.policy(claim_a7,policy1) +| Call: policy.type(policy1,V1032) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a7,policy1,cardinal) +| | Call: valid_insuree(claim_a7,policy1) +| | | Call: claim.claimant(claim_a7,V1237) +| | | Exit: claim.claimant(claim_a7,person_a7) +| | | Call: policy.insuree(policy1,person_a7) +| | | Exit: policy.insuree(policy1,person_a7) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a7,policy1) +| | | Call: claim.claimant(claim_a7,V1238) +| | | Exit: claim.claimant(claim_a7,person_a7) +| | | Call: claim.hosp_start_time(claim_a7,V1239,V1240) +| | | Exit: claim.hosp_start_time(claim_a7,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a7,V1241,V1242) +| | | Exit: claim.hosp_end_time(claim_a7,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a7,V1243) +| | | Exit: policy.startdate(policy1,person_a7,01_08_2023) +| | | Call: policy.enddate(policy1,person_a7,V1244) +| | | Exit: policy.enddate(policy1,person_a7,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V1245) +| | | | Call: evaluate(parsedate(03_09_2023),[V1246,V1247,V1248]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1245) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V1249) +| | | | Call: evaluate(parsedate(03_09_2023),[V1250,V1251,V1252]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1249) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1253) +| | | | Call: evaluate(parsedate(30_06_2024),[V1254,V1255,V1256]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1253) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1257) +| | | | Call: evaluate(parsedate(01_08_2023),[V1258,V1259,V1260]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1257) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a7,policy1) +| | | Call: claim.hospital(claim_a7,V1261) +| | | Exit: claim.hospital(claim_a7,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a7,V1262) +| | | Exit: claim.reason(claim_a7,preventive_care) +| | | Call: eligible_service(claim_a7,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a7,preventive_care) +| | | | | Call: claim.claimant(claim_a7,V1263) +| | | | | Exit: claim.claimant(claim_a7,person_a7) +| | | | | Call: person.dob(person_a7,V1264) +| | | | | Exit: person.dob(person_a7,04_08_2023) +| | | | | Call: claim.time(claim_a7,V1265,V1266) +| | | | | Fail: claim.time(claim_a7,V1265,V1266) +| | | | | Redo: person.dob(person_a7,V1264) +| | | | | Fail: person.dob(person_a7,V1264) +| | | | | Redo: claim.claimant(claim_a7,V1263) +| | | | | Fail: claim.claimant(claim_a7,V1263) +| | | | Fail: check_policy_year_limit(claim_a7,preventive_care) +| | | | Call: covered_list_with_location(V1267) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1267) +| | | | Fail: covered_list_with_location(V1267) +| | | | Call: covered_list_with_service_provider(V1268) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1268) +| | | | Fail: covered_list_with_service_provider(V1268) +| | | | Call: covered_list(V1269) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1269) +| | | | Fail: covered_list(V1269) +| | | | Call: claim.location(claim_a7,V1270) +| | | | Exit: claim.location(claim_a7,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a7,hep_b) +| | | | Exit: claim.vaccine(claim_a7,hep_b) +| | | | Call: claim.claimant(claim_a7,V1271) +| | | | Exit: claim.claimant(claim_a7,person_a7) +| | | | Call: person.dob(person_a7,V1272) +| | | | Exit: person.dob(person_a7,04_08_2023) +| | | | Call: claim.hosp_start_time(claim_a7,V1273,V1274) +| | | | Exit: claim.hosp_start_time(claim_a7,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_08_2023,V1275) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1276,V1277,V1278]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1279,V1280,V1281]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1282) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1283) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1284) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,1),-1),V1285) +| | | | | Exit: evaluate(plus(imul(31,1),-1),30) +| | | | | Call: evaluate(plus(0,if(leq(30,-1),-1,true,0)),V1275) +| | | | | Exit: evaluate(plus(0,if(leq(30,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_08_2023,V1286) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1287,V1288,V1289]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1290,V1291,V1292]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1293) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1294) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1295) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),1),V1296) +| | | | | Exit: evaluate(plus(imul(12,0),1),1) +| | | | | Call: evaluate(if(leq(-1,-1),minus(1,1),true,1),V1286) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(1,1),true,1),0) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: age_range_limit_hepb(claim_a7,V1297,0,0) +| | | | Exit: age_range_limit_hepb(C,1,Y,0) +| | | | Call: claim.vaccine_dose_count(claim_a7,V1298) +| | | | Exit: claim.vaccine_dose_count(claim_a7,7) +| | | | Call: leq(7,1) +| | | | Fail: leq(7,1) +| | | | Redo: claim.vaccine_dose_count(claim_a7,V1298) +| | | | Fail: claim.vaccine_dose_count(claim_a7,V1298) +| | | | Redo: age_range_limit_hepb(claim_a7,V1297,0,0) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(6,0) +| | | | | Fail: leq(6,0) +| | | | | Call: leq(19,0) +| | | | | Fail: leq(19,0) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: mother_hbsag_positive_unknown(claim_a7) +| | | | | | Call: claim.mother_hbsag(claim_a7,positive) +| | | | | | Fail: claim.mother_hbsag(claim_a7,positive) +| | | | | | Call: claim.mother_hbsag(V1299,unknown) +| | | | | | Fail: claim.mother_hbsag(V1299,unknown) +| | | | | Fail: mother_hbsag_positive_unknown(claim_a7) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: claim.birth_weight(claim_a7,V1300) +| | | | | Exit: claim.birth_weight(claim_a7,2001) +| | | | | Call: leq(2001,2000) +| | | | | Fail: leq(2001,2000) +| | | | | Redo: claim.birth_weight(claim_a7,V1300) +| | | | | Fail: claim.birth_weight(claim_a7,V1300) +| | | | | Call: claim.claimant(claim_a7,V1301) +| | | | | Exit: claim.claimant(claim_a7,person_a7) +| | | | | Call: eligible_for_revaccination(person_a7) +| | | | | | Call: person.occupation(person_a7,healthcare_worker) +| | | | | | Fail: person.occupation(person_a7,healthcare_worker) +| | | | | | Call: person.condition(person_a7,immunocompromised) +| | | | | | Fail: person.condition(person_a7,immunocompromised) +| | | | | | Call: person.condition(person_a7,hemodialysis_patient) +| | | | | | Fail: person.condition(person_a7,hemodialysis_patient) +| | | | | Fail: eligible_for_revaccination(person_a7) +| | | | | Redo: claim.claimant(claim_a7,V1301) +| | | | | Fail: claim.claimant(claim_a7,V1301) +| | | | Fail: age_range_limit_hepb(claim_a7,V1297,0,0) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_08_2023,V1286) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_08_2023,V1275) +| | | | Redo: claim.hosp_start_time(claim_a7,V1273,V1274) +| | | | Fail: claim.hosp_start_time(claim_a7,V1273,V1274) +| | | | Redo: person.dob(person_a7,V1272) +| | | | Fail: person.dob(person_a7,V1272) +| | | | Redo: claim.claimant(claim_a7,V1271) +| | | | Fail: claim.claimant(claim_a7,V1271) +| | | | Redo: claim.vaccine(claim_a7,hep_b) +| | | | Fail: claim.vaccine(claim_a7,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a7,V1270) +| | | | Fail: claim.location(claim_a7,V1270) +| | | | Call: claim.location(claim_a7,V1302) +| | | | Exit: claim.location(claim_a7,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a7,covid) +| | | | Fail: claim.vaccine(claim_a7,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a7,V1302) +| | | | Fail: claim.location(claim_a7,V1302) +| | | | Call: claim.location(claim_a7,V1303) +| | | | Exit: claim.location(claim_a7,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a7,flu) +| | | | Fail: claim.vaccine(claim_a7,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a7,V1303) +| | | | Fail: claim.location(claim_a7,V1303) +| | | Fail: eligible_service(claim_a7,policy1,preventive_care) +| | | Redo: claim.reason(claim_a7,V1262) +| | | Fail: claim.reason(claim_a7,V1262) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a7,V1261) +| | | Fail: claim.hospital(claim_a7,V1261) +| | | Call: claim.reason(claim_a7,emergency_room) +| | | Fail: claim.reason(claim_a7,emergency_room) +| | Fail: valid_hospitalization(claim_a7,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1257) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1253) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1249) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1245) +| | | Redo: policy.enddate(policy1,person_a7,V1244) +| | | Fail: policy.enddate(policy1,person_a7,V1244) +| | | Redo: policy.startdate(policy1,person_a7,V1243) +| | | Fail: policy.startdate(policy1,person_a7,V1243) +| | | Redo: claim.hosp_end_time(claim_a7,V1241,V1242) +| | | Fail: claim.hosp_end_time(claim_a7,V1241,V1242) +| | | Redo: claim.hosp_start_time(claim_a7,V1239,V1240) +| | | Fail: claim.hosp_start_time(claim_a7,V1239,V1240) +| | | Redo: claim.claimant(claim_a7,V1238) +| | | Fail: claim.claimant(claim_a7,V1238) +| | Fail: policy_active(claim_a7,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a7) +| | | Fail: policy.insuree(policy1,person_a7) +| | | Redo: claim.claimant(claim_a7,V1237) +| | | Fail: claim.claimant(claim_a7,V1237) +| | Fail: valid_insuree(claim_a7,policy1) +| Fail: covered_under_policy(claim_a7,policy1,cardinal) +| Redo: policy.type(policy1,V1032) +| Fail: policy.type(policy1,V1032) +| Redo: claim.policy(X,V1031) +| Exit: claim.policy(claim_a8,policy1) +| Call: policy.type(policy1,V1032) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a8,policy1,cardinal) +| | Call: valid_insuree(claim_a8,policy1) +| | | Call: claim.claimant(claim_a8,V1304) +| | | Exit: claim.claimant(claim_a8,person_a8) +| | | Call: policy.insuree(policy1,person_a8) +| | | Exit: policy.insuree(policy1,person_a8) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a8,policy1) +| | | Call: claim.claimant(claim_a8,V1305) +| | | Exit: claim.claimant(claim_a8,person_a8) +| | | Call: claim.hosp_start_time(claim_a8,V1306,V1307) +| | | Exit: claim.hosp_start_time(claim_a8,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a8,V1308,V1309) +| | | Exit: claim.hosp_end_time(claim_a8,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a8,V1310) +| | | Exit: policy.startdate(policy1,person_a8,01_08_2023) +| | | Call: policy.enddate(policy1,person_a8,V1311) +| | | Exit: policy.enddate(policy1,person_a8,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V1312) +| | | | Call: evaluate(parsedate(03_09_2023),[V1313,V1314,V1315]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1312) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V1316) +| | | | Call: evaluate(parsedate(03_09_2023),[V1317,V1318,V1319]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1316) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1320) +| | | | Call: evaluate(parsedate(30_06_2024),[V1321,V1322,V1323]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1320) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1324) +| | | | Call: evaluate(parsedate(01_08_2023),[V1325,V1326,V1327]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1324) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a8,policy1) +| | | Call: claim.hospital(claim_a8,V1328) +| | | Exit: claim.hospital(claim_a8,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a8,V1329) +| | | Exit: claim.reason(claim_a8,preventive_care) +| | | Call: eligible_service(claim_a8,policy1,preventive_care) +| | | | Call: check_policy_year_limit(claim_a8,preventive_care) +| | | | | Call: claim.claimant(claim_a8,V1330) +| | | | | Exit: claim.claimant(claim_a8,person_a8) +| | | | | Call: person.dob(person_a8,V1331) +| | | | | Exit: person.dob(person_a8,04_08_2023) +| | | | | Call: claim.time(claim_a8,V1332,V1333) +| | | | | Fail: claim.time(claim_a8,V1332,V1333) +| | | | | Redo: person.dob(person_a8,V1331) +| | | | | Fail: person.dob(person_a8,V1331) +| | | | | Redo: claim.claimant(claim_a8,V1330) +| | | | | Fail: claim.claimant(claim_a8,V1330) +| | | | Fail: check_policy_year_limit(claim_a8,preventive_care) +| | | | Call: covered_list_with_location(V1334) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(preventive_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1334) +| | | | Fail: covered_list_with_location(V1334) +| | | | Call: covered_list_with_service_provider(V1335) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(preventive_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1335) +| | | | Fail: covered_list_with_service_provider(V1335) +| | | | Call: covered_list(V1336) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(preventive_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1336) +| | | | Fail: covered_list(V1336) +| | | | Call: claim.location(claim_a8,V1337) +| | | | Exit: claim.location(claim_a8,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a8,hep_b) +| | | | Exit: claim.vaccine(claim_a8,hep_b) +| | | | Call: claim.claimant(claim_a8,V1338) +| | | | Exit: claim.claimant(claim_a8,person_a8) +| | | | Call: person.dob(person_a8,V1339) +| | | | Exit: person.dob(person_a8,04_08_2023) +| | | | Call: claim.hosp_start_time(claim_a8,V1340,V1341) +| | | | Exit: claim.hosp_start_time(claim_a8,03_09_2023,00_00) +| | | | Call: get_date_diff(03_09_2023,04_08_2023,V1342) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1343,V1344,V1345]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1346,V1347,V1348]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1349) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1350) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1351) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(31,1),-1),V1352) +| | | | | Exit: evaluate(plus(imul(31,1),-1),30) +| | | | | Call: evaluate(plus(0,if(leq(30,-1),-1,true,0)),V1342) +| | | | | Exit: evaluate(plus(0,if(leq(30,-1),-1,true,0)),0) +| | | | Exit: get_date_diff(C_D,DOB,Y) +| | | | Call: get_date_diff_in_months(03_09_2023,04_08_2023,V1353) +| | | | | Call: evaluate(parsedate(03_09_2023),[V1354,V1355,V1356]) +| | | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | | Call: evaluate(parsedate(04_08_2023),[V1357,V1358,V1359]) +| | | | | Exit: evaluate(parsedate(04_08_2023),[04,08,2023]) +| | | | | Call: evaluate(minus(2023,2023),V1360) +| | | | | Exit: evaluate(minus(2023,2023),0) +| | | | | Call: evaluate(minus(09,08),V1361) +| | | | | Exit: evaluate(minus(09,08),1) +| | | | | Call: evaluate(minus(03,04),V1362) +| | | | | Exit: evaluate(minus(03,04),-1) +| | | | | Call: evaluate(plus(imul(12,0),1),V1363) +| | | | | Exit: evaluate(plus(imul(12,0),1),1) +| | | | | Call: evaluate(if(leq(-1,-1),minus(1,1),true,1),V1353) +| | | | | Exit: evaluate(if(leq(-1,-1),minus(1,1),true,1),0) +| | | | Exit: get_date_diff_in_months(C_D,DOB,M) +| | | | Call: age_range_limit_hepb(claim_a8,V1364,0,0) +| | | | Exit: age_range_limit_hepb(C,1,Y,0) +| | | | Call: claim.vaccine_dose_count(claim_a8,V1365) +| | | | Exit: claim.vaccine_dose_count(claim_a8,8) +| | | | Call: leq(8,1) +| | | | Fail: leq(8,1) +| | | | Redo: claim.vaccine_dose_count(claim_a8,V1365) +| | | | Fail: claim.vaccine_dose_count(claim_a8,V1365) +| | | | Redo: age_range_limit_hepb(claim_a8,V1364,0,0) +| | | | | Call: leq(2,0) +| | | | | Fail: leq(2,0) +| | | | | Call: leq(6,0) +| | | | | Fail: leq(6,0) +| | | | | Call: leq(19,0) +| | | | | Fail: leq(19,0) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: mother_hbsag_positive_unknown(claim_a8) +| | | | | | Call: claim.mother_hbsag(claim_a8,positive) +| | | | | | Fail: claim.mother_hbsag(claim_a8,positive) +| | | | | | Call: claim.mother_hbsag(V1366,unknown) +| | | | | | Fail: claim.mother_hbsag(V1366,unknown) +| | | | | Fail: mother_hbsag_positive_unknown(claim_a8) +| | | | | Call: leq(0,2) +| | | | | Exit: leq(0,2) +| | | | | Call: claim.birth_weight(claim_a8,V1367) +| | | | | Exit: claim.birth_weight(claim_a8,1999) +| | | | | Call: leq(1999,2000) +| | | | | Exit: leq(1999,2000) +| | | | | Call: claim.anti_hbs_count(claim_a8,V1368) +| | | | | Exit: claim.anti_hbs_count(claim_a8,9) +| | | | | Call: leq(9,10) +| | | | | Exit: leq(9,10) +| | | | Exit: age_range_limit_hepb(C,N,Y,M) +| | | | Call: claim.vaccine_dose_count(claim_a8,V1365) +| | | | Exit: claim.vaccine_dose_count(claim_a8,8) +| | | | Call: leq(8,7) +| | | | Fail: leq(8,7) +| | | | Redo: claim.vaccine_dose_count(claim_a8,V1365) +| | | | Fail: claim.vaccine_dose_count(claim_a8,V1365) +| | | | Redo: age_range_limit_hepb(C,N,Y,M) +| | | | | Redo: claim.anti_hbs_count(claim_a8,V1368) +| | | | | Fail: claim.anti_hbs_count(claim_a8,V1368) +| | | | | Redo: claim.birth_weight(claim_a8,V1367) +| | | | | Fail: claim.birth_weight(claim_a8,V1367) +| | | | | Call: claim.claimant(claim_a8,V1369) +| | | | | Exit: claim.claimant(claim_a8,person_a8) +| | | | | Call: eligible_for_revaccination(person_a8) +| | | | | | Call: person.occupation(person_a8,healthcare_worker) +| | | | | | Fail: person.occupation(person_a8,healthcare_worker) +| | | | | | Call: person.condition(person_a8,immunocompromised) +| | | | | | Fail: person.condition(person_a8,immunocompromised) +| | | | | | Call: person.condition(person_a8,hemodialysis_patient) +| | | | | | Fail: person.condition(person_a8,hemodialysis_patient) +| | | | | Fail: eligible_for_revaccination(person_a8) +| | | | | Redo: claim.claimant(claim_a8,V1369) +| | | | | Fail: claim.claimant(claim_a8,V1369) +| | | | Fail: age_range_limit_hepb(claim_a8,V1364,0,0) +| | | | Redo: get_date_diff_in_months(C_D,DOB,M) +| | | | Fail: get_date_diff_in_months(03_09_2023,04_08_2023,V1353) +| | | | Redo: get_date_diff(C_D,DOB,Y) +| | | | Fail: get_date_diff(03_09_2023,04_08_2023,V1342) +| | | | Redo: claim.hosp_start_time(claim_a8,V1340,V1341) +| | | | Fail: claim.hosp_start_time(claim_a8,V1340,V1341) +| | | | Redo: person.dob(person_a8,V1339) +| | | | Fail: person.dob(person_a8,V1339) +| | | | Redo: claim.claimant(claim_a8,V1338) +| | | | Fail: claim.claimant(claim_a8,V1338) +| | | | Redo: claim.vaccine(claim_a8,hep_b) +| | | | Fail: claim.vaccine(claim_a8,hep_b) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a8,V1337) +| | | | Fail: claim.location(claim_a8,V1337) +| | | | Call: claim.location(claim_a8,V1370) +| | | | Exit: claim.location(claim_a8,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a8,covid) +| | | | Fail: claim.vaccine(claim_a8,covid) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a8,V1370) +| | | | Fail: claim.location(claim_a8,V1370) +| | | | Call: claim.location(claim_a8,V1371) +| | | | Exit: claim.location(claim_a8,phys_office) +| | | | Call: valid_location(preventive_care,phys_office) +| | | | Exit: valid_location(preventive_care,phys_office) +| | | | Call: claim.vaccine(claim_a8,flu) +| | | | Fail: claim.vaccine(claim_a8,flu) +| | | | Redo: valid_location(preventive_care,phys_office) +| | | | Fail: valid_location(preventive_care,phys_office) +| | | | Redo: claim.location(claim_a8,V1371) +| | | | Fail: claim.location(claim_a8,V1371) +| | | Fail: eligible_service(claim_a8,policy1,preventive_care) +| | | Redo: claim.reason(claim_a8,V1329) +| | | Fail: claim.reason(claim_a8,V1329) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a8,V1328) +| | | Fail: claim.hospital(claim_a8,V1328) +| | | Call: claim.reason(claim_a8,emergency_room) +| | | Fail: claim.reason(claim_a8,emergency_room) +| | Fail: valid_hospitalization(claim_a8,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1324) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1320) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1316) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1312) +| | | Redo: policy.enddate(policy1,person_a8,V1311) +| | | Fail: policy.enddate(policy1,person_a8,V1311) +| | | Redo: policy.startdate(policy1,person_a8,V1310) +| | | Fail: policy.startdate(policy1,person_a8,V1310) +| | | Redo: claim.hosp_end_time(claim_a8,V1308,V1309) +| | | Fail: claim.hosp_end_time(claim_a8,V1308,V1309) +| | | Redo: claim.hosp_start_time(claim_a8,V1306,V1307) +| | | Fail: claim.hosp_start_time(claim_a8,V1306,V1307) +| | | Redo: claim.claimant(claim_a8,V1305) +| | | Fail: claim.claimant(claim_a8,V1305) +| | Fail: policy_active(claim_a8,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a8) +| | | Fail: policy.insuree(policy1,person_a8) +| | | Redo: claim.claimant(claim_a8,V1304) +| | | Fail: claim.claimant(claim_a8,V1304) +| | Fail: valid_insuree(claim_a8,policy1) +| Fail: covered_under_policy(claim_a8,policy1,cardinal) +| Redo: policy.type(policy1,V1032) +| Fail: policy.type(policy1,V1032) +| Redo: claim.policy(X,V1031) +| Fail: claim.policy(X,V1031) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_hepb.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim_a4', 'claim_a6' ] +RESULTS: [ 'claim_a4', 'claim_a6' ] +===== TEST SUCCEEDED: Test test_cases_hepb.hdf===== +Expected Result: [ 'claim8' ] +Call: covered(X) +| Call: claim.policy(X,V1372) +| Exit: claim.policy(claim8,policy1) +| Call: policy.type(policy1,V1373) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim8,policy1,cardinal) +| | Call: valid_insuree(claim8,policy1) +| | | Call: claim.claimant(claim8,V1374) +| | | Exit: claim.claimant(claim8,person5) +| | | Call: policy.insuree(policy1,person5) +| | | Exit: policy.insuree(policy1,person5) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim8,policy1) +| | | Call: claim.claimant(claim8,V1375) +| | | Exit: claim.claimant(claim8,person5) +| | | Call: claim.hosp_start_time(claim8,V1376,V1377) +| | | Exit: claim.hosp_start_time(claim8,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim8,V1378,V1379) +| | | Exit: claim.hosp_end_time(claim8,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person5,V1380) +| | | Exit: policy.startdate(policy1,person5,01_08_2023) +| | | Call: policy.enddate(policy1,person5,V1381) +| | | Exit: policy.enddate(policy1,person5,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1382) +| | | | Call: evaluate(parsedate(02_09_2023),[V1383,V1384,V1385]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1382) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1386) +| | | | Call: evaluate(parsedate(02_09_2023),[V1387,V1388,V1389]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1386) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1390) +| | | | Call: evaluate(parsedate(30_06_2024),[V1391,V1392,V1393]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1390) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1394) +| | | | Call: evaluate(parsedate(01_08_2023),[V1395,V1396,V1397]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1394) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim8,policy1) +| | | Call: claim.hospital(claim8,V1398) +| | | Exit: claim.hospital(claim8,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim8,V1399) +| | | Exit: claim.reason(claim8,home_health_care) +| | | Call: eligible_service(claim8,policy1,home_health_care) +| | | | Call: check_policy_year_limit(claim8,home_health_care) +| | | | | Call: claim.claimant(claim8,V1400) +| | | | | Exit: claim.claimant(claim8,person5) +| | | | | Call: person.dob(person5,V1401) +| | | | | Exit: person.dob(person5,01_01_2007) +| | | | | Call: claim.time(claim8,V1402,V1403) +| | | | | Exit: claim.time(claim8,01_02_2024,00_00) +| | | | | Call: get_date_diff(01_02_2024,01_01_2007,V1404) +| | | | | | Call: evaluate(parsedate(01_02_2024),[V1405,V1406,V1407]) +| | | | | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2007),[V1408,V1409,V1410]) +| | | | | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | | | | Call: evaluate(minus(2024,2007),V1411) +| | | | | | Exit: evaluate(minus(2024,2007),17) +| | | | | | Call: evaluate(minus(02,01),V1412) +| | | | | | Exit: evaluate(minus(02,01),1) +| | | | | | Call: evaluate(minus(01,01),V1413) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,1),0),V1414) +| | | | | | Exit: evaluate(plus(imul(31,1),0),31) +| | | | | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1404) +| | | | | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(home_health_care,17,V1415) +| | | | | | Call: yearly_visit_limit(home_health_care,V1416,V1417,V1415) +| | | | | | Exit: yearly_visit_limit(home_health_care,0,200,100) +| | | | | | Call: evaluate(minus(200,1),V1418) +| | | | | | Exit: evaluate(minus(200,1),199) +| | | | | | Call: leq(17,199) +| | | | | | Exit: leq(17,199) +| | | | | | Call: leq(0,17) +| | | | | | Exit: leq(0,17) +| | | | | Exit: yearly_visit_limit(Service,Age,Limit) +| | | | | Call: evaluate(plus(countofall(V1419,visit_current_year(home_health_care,claim8,V1419)),1),V1420) +| | | | | Exit: evaluate(plus(countofall(V1422,visit_current_year(home_health_care,claim8,V1422)),1),1) +| | | | | Call: leq(1,100) +| | | | | Exit: leq(1,100) +| | | | Exit: check_policy_year_limit(C,Service) +| | | | Call: claim.location(claim8,V1423) +| | | | Exit: claim.location(claim8,home) +| | | | Call: valid_location(home_health_care,home) +| | | | Exit: valid_location(home_health_care,home) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim8,policy1) +Call: exception(claim8,policy1) +| Call: claim.claimant(claim8,V1424) +| Exit: claim.claimant(claim8,person5) +| Call: person.occupation(person5,armed_forces) +| Fail: person.occupation(person5,armed_forces) +| Redo: claim.claimant(claim8,V1424) +| Fail: claim.claimant(claim8,V1424) +| Call: claim.reason(claim8,home_health_care) +| Exit: claim.reason(claim8,home_health_care) +| Call: home_not_covered_list(V1425) +| Exit: home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Call: claim.home_service(claim8,V1426) +| Exit: claim.home_service(claim8,other) +| Call: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Fail: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Redo: claim.home_service(claim8,V1426) +| Fail: claim.home_service(claim8,V1426) +| Redo: home_not_covered_list(V1425) +| Fail: home_not_covered_list(V1425) +| Redo: claim.reason(claim8,home_health_care) +| Fail: claim.reason(claim8,home_health_care) +| Call: claim.reason(claim8,home_health_care) +| Exit: claim.reason(claim8,home_health_care) +| Call: claim.claimant(claim8,V1427) +| Exit: claim.claimant(claim8,person5) +| Call: minor_or_dependent(claim8,person5) +| | Call: person.dependent(person5,yes) +| | Fail: person.dependent(person5,yes) +| | Call: person.dob(person5,V1428) +| | Exit: person.dob(person5,01_01_2007) +| | Call: claim.time(claim8,V1429,V1430) +| | Exit: claim.time(claim8,01_02_2024,00_00) +| | Call: get_date_diff(01_02_2024,01_01_2007,V1431) +| | | Call: evaluate(parsedate(01_02_2024),[V1432,V1433,V1434]) +| | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | Call: evaluate(parsedate(01_01_2007),[V1435,V1436,V1437]) +| | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | Call: evaluate(minus(2024,2007),V1438) +| | | Exit: evaluate(minus(2024,2007),17) +| | | Call: evaluate(minus(02,01),V1439) +| | | Exit: evaluate(minus(02,01),1) +| | | Call: evaluate(minus(01,01),V1440) +| | | Exit: evaluate(minus(01,01),0) +| | | Call: evaluate(plus(imul(31,1),0),V1441) +| | | Exit: evaluate(plus(imul(31,1),0),31) +| | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1431) +| | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | Exit: get_date_diff(C_D,DOB,Age) +| | Call: leq(17,17) +| | Exit: leq(17,17) +| Exit: minor_or_dependent(C,Cl) +| Call: claim.family_member_present(claim8,no) +| Fail: claim.family_member_present(claim8,no) +| Redo: minor_or_dependent(C,Cl) +| | Redo: get_date_diff(C_D,DOB,Age) +| | Fail: get_date_diff(01_02_2024,01_01_2007,V1431) +| | Redo: claim.time(claim8,V1429,V1430) +| | Fail: claim.time(claim8,V1429,V1430) +| | Redo: person.dob(person5,V1428) +| | Fail: person.dob(person5,V1428) +| Fail: minor_or_dependent(claim8,person5) +| Redo: claim.claimant(claim8,V1427) +| Fail: claim.claimant(claim8,V1427) +| Redo: claim.reason(claim8,home_health_care) +| Fail: claim.reason(claim8,home_health_care) +Fail: exception(claim8,policy1) +| | | Exit: ~exception(claim8,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim8) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(home_health_care,home) +| | | | Fail: valid_location(home_health_care,home) +| | | | Redo: claim.location(claim8,V1423) +| | | | Fail: claim.location(claim8,V1423) +| | | | Redo: check_policy_year_limit(C,Service) +| | | | | Redo: yearly_visit_limit(Service,Age,Limit) +| | | | | | Redo: yearly_visit_limit(home_health_care,V1416,V1417,V1415) +| | | | | | Fail: yearly_visit_limit(home_health_care,V1416,V1417,V1415) +| | | | | Fail: yearly_visit_limit(home_health_care,17,V1415) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_02_2024,01_01_2007,V1404) +| | | | | Redo: claim.time(claim8,V1402,V1403) +| | | | | Fail: claim.time(claim8,V1402,V1403) +| | | | | Redo: person.dob(person5,V1401) +| | | | | Fail: person.dob(person5,V1401) +| | | | | Redo: claim.claimant(claim8,V1400) +| | | | | Fail: claim.claimant(claim8,V1400) +| | | | Fail: check_policy_year_limit(claim8,home_health_care) +| | | | Call: covered_list_with_location(V1442) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Exit: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: claim.location(claim8,V1443) +| | | | Exit: claim.location(claim8,home) +| | | | Call: valid_location(home_health_care,home) +| | | | Exit: valid_location(home_health_care,home) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim8,policy1) +Call: exception(claim8,policy1) +| Call: claim.claimant(claim8,V1444) +| Exit: claim.claimant(claim8,person5) +| Call: person.occupation(person5,armed_forces) +| Fail: person.occupation(person5,armed_forces) +| Redo: claim.claimant(claim8,V1444) +| Fail: claim.claimant(claim8,V1444) +| Call: claim.reason(claim8,home_health_care) +| Exit: claim.reason(claim8,home_health_care) +| Call: home_not_covered_list(V1445) +| Exit: home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Call: claim.home_service(claim8,V1446) +| Exit: claim.home_service(claim8,other) +| Call: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Fail: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Redo: claim.home_service(claim8,V1446) +| Fail: claim.home_service(claim8,V1446) +| Redo: home_not_covered_list(V1445) +| Fail: home_not_covered_list(V1445) +| Redo: claim.reason(claim8,home_health_care) +| Fail: claim.reason(claim8,home_health_care) +| Call: claim.reason(claim8,home_health_care) +| Exit: claim.reason(claim8,home_health_care) +| Call: claim.claimant(claim8,V1447) +| Exit: claim.claimant(claim8,person5) +| Call: minor_or_dependent(claim8,person5) +| | Call: person.dependent(person5,yes) +| | Fail: person.dependent(person5,yes) +| | Call: person.dob(person5,V1448) +| | Exit: person.dob(person5,01_01_2007) +| | Call: claim.time(claim8,V1449,V1450) +| | Exit: claim.time(claim8,01_02_2024,00_00) +| | Call: get_date_diff(01_02_2024,01_01_2007,V1451) +| | | Call: evaluate(parsedate(01_02_2024),[V1452,V1453,V1454]) +| | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | Call: evaluate(parsedate(01_01_2007),[V1455,V1456,V1457]) +| | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | Call: evaluate(minus(2024,2007),V1458) +| | | Exit: evaluate(minus(2024,2007),17) +| | | Call: evaluate(minus(02,01),V1459) +| | | Exit: evaluate(minus(02,01),1) +| | | Call: evaluate(minus(01,01),V1460) +| | | Exit: evaluate(minus(01,01),0) +| | | Call: evaluate(plus(imul(31,1),0),V1461) +| | | Exit: evaluate(plus(imul(31,1),0),31) +| | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1451) +| | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | Exit: get_date_diff(C_D,DOB,Age) +| | Call: leq(17,17) +| | Exit: leq(17,17) +| Exit: minor_or_dependent(C,Cl) +| Call: claim.family_member_present(claim8,no) +| Fail: claim.family_member_present(claim8,no) +| Redo: minor_or_dependent(C,Cl) +| | Redo: get_date_diff(C_D,DOB,Age) +| | Fail: get_date_diff(01_02_2024,01_01_2007,V1451) +| | Redo: claim.time(claim8,V1449,V1450) +| | Fail: claim.time(claim8,V1449,V1450) +| | Redo: person.dob(person5,V1448) +| | Fail: person.dob(person5,V1448) +| Fail: minor_or_dependent(claim8,person5) +| Redo: claim.claimant(claim8,V1447) +| Fail: claim.claimant(claim8,V1447) +| Redo: claim.reason(claim8,home_health_care) +| Fail: claim.reason(claim8,home_health_care) +Fail: exception(claim8,policy1) +| | | Exit: ~exception(claim8,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim8) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(home_health_care,home) +| | | | Fail: valid_location(home_health_care,home) +| | | | Redo: claim.location(claim8,V1443) +| | | | Fail: claim.location(claim8,V1443) +| | | | Redo: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1442) +| | | | Fail: covered_list_with_location(V1442) +| | | | Call: covered_list_with_service_provider(V1462) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(home_health_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(home_health_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1462) +| | | | Fail: covered_list_with_service_provider(V1462) +| | | | Call: covered_list(V1463) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(home_health_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(home_health_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1463) +| | | | Fail: covered_list(V1463) +| | | Fail: eligible_service(claim8,policy1,home_health_care) +| | | Redo: claim.reason(claim8,V1399) +| | | Fail: claim.reason(claim8,V1399) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim8,V1398) +| | | Fail: claim.hospital(claim8,V1398) +| | | Call: claim.reason(claim8,emergency_room) +| | | Fail: claim.reason(claim8,emergency_room) +| | Fail: valid_hospitalization(claim8,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1394) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1390) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1386) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1382) +| | | Redo: policy.enddate(policy1,person5,V1381) +| | | Fail: policy.enddate(policy1,person5,V1381) +| | | Redo: policy.startdate(policy1,person5,V1380) +| | | Fail: policy.startdate(policy1,person5,V1380) +| | | Redo: claim.hosp_end_time(claim8,V1378,V1379) +| | | Fail: claim.hosp_end_time(claim8,V1378,V1379) +| | | Redo: claim.hosp_start_time(claim8,V1376,V1377) +| | | Fail: claim.hosp_start_time(claim8,V1376,V1377) +| | | Redo: claim.claimant(claim8,V1375) +| | | Fail: claim.claimant(claim8,V1375) +| | Fail: policy_active(claim8,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person5) +| | | Fail: policy.insuree(policy1,person5) +| | | Redo: claim.claimant(claim8,V1374) +| | | Fail: claim.claimant(claim8,V1374) +| | Fail: valid_insuree(claim8,policy1) +| Fail: covered_under_policy(claim8,policy1,cardinal) +| Redo: policy.type(policy1,V1373) +| Fail: policy.type(policy1,V1373) +| Redo: claim.policy(X,V1372) +| Exit: claim.policy(claim9,policy1) +| Call: policy.type(policy1,V1373) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim9,policy1,cardinal) +| | Call: valid_insuree(claim9,policy1) +| | | Call: claim.claimant(claim9,V1464) +| | | Exit: claim.claimant(claim9,person5) +| | | Call: policy.insuree(policy1,person5) +| | | Exit: policy.insuree(policy1,person5) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim9,policy1) +| | | Call: claim.claimant(claim9,V1465) +| | | Exit: claim.claimant(claim9,person5) +| | | Call: claim.hosp_start_time(claim9,V1466,V1467) +| | | Exit: claim.hosp_start_time(claim9,02_08_2023,00_00) +| | | Call: claim.hosp_end_time(claim9,V1468,V1469) +| | | Exit: claim.hosp_end_time(claim9,02_08_2023,01_13) +| | | Call: policy.startdate(policy1,person5,V1470) +| | | Exit: policy.startdate(policy1,person5,01_08_2023) +| | | Call: policy.enddate(policy1,person5,V1471) +| | | Exit: policy.enddate(policy1,person5,30_06_2024) +| | | Call: get_timestamp_from_date(02_08_2023,V1472) +| | | | Call: evaluate(parsedate(02_08_2023),[V1473,V1474,V1475]) +| | | | Exit: evaluate(parsedate(02_08_2023),[02,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V1472) +| | | | Exit: evaluate(maketimestamp(2023,08,02,0,0,0),1690959600000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_08_2023,V1476) +| | | | Call: evaluate(parsedate(02_08_2023),[V1477,V1478,V1479]) +| | | | Exit: evaluate(parsedate(02_08_2023),[02,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V1476) +| | | | Exit: evaluate(maketimestamp(2023,08,02,0,0,0),1690959600000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1480) +| | | | Call: evaluate(parsedate(30_06_2024),[V1481,V1482,V1483]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1480) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1484) +| | | | Call: evaluate(parsedate(01_08_2023),[V1485,V1486,V1487]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1484) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1690959600000) +| | | Exit: leq(1690873200000,1690959600000) +| | | Call: leq(1690959600000,1719730800000) +| | | Exit: leq(1690959600000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim9,policy1) +| | | Call: claim.hospital(claim9,V1488) +| | | Exit: claim.hospital(claim9,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim9,V1489) +| | | Exit: claim.reason(claim9,home_health_care) +| | | Call: eligible_service(claim9,policy1,home_health_care) +| | | | Call: check_policy_year_limit(claim9,home_health_care) +| | | | | Call: claim.claimant(claim9,V1490) +| | | | | Exit: claim.claimant(claim9,person5) +| | | | | Call: person.dob(person5,V1491) +| | | | | Exit: person.dob(person5,01_01_2007) +| | | | | Call: claim.time(claim9,V1492,V1493) +| | | | | Exit: claim.time(claim9,01_02_2024,00_00) +| | | | | Call: get_date_diff(01_02_2024,01_01_2007,V1494) +| | | | | | Call: evaluate(parsedate(01_02_2024),[V1495,V1496,V1497]) +| | | | | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2007),[V1498,V1499,V1500]) +| | | | | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | | | | Call: evaluate(minus(2024,2007),V1501) +| | | | | | Exit: evaluate(minus(2024,2007),17) +| | | | | | Call: evaluate(minus(02,01),V1502) +| | | | | | Exit: evaluate(minus(02,01),1) +| | | | | | Call: evaluate(minus(01,01),V1503) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,1),0),V1504) +| | | | | | Exit: evaluate(plus(imul(31,1),0),31) +| | | | | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1494) +| | | | | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(home_health_care,17,V1505) +| | | | | | Call: yearly_visit_limit(home_health_care,V1506,V1507,V1505) +| | | | | | Exit: yearly_visit_limit(home_health_care,0,200,100) +| | | | | | Call: evaluate(minus(200,1),V1508) +| | | | | | Exit: evaluate(minus(200,1),199) +| | | | | | Call: leq(17,199) +| | | | | | Exit: leq(17,199) +| | | | | | Call: leq(0,17) +| | | | | | Exit: leq(0,17) +| | | | | Exit: yearly_visit_limit(Service,Age,Limit) +| | | | | Call: evaluate(plus(countofall(V1509,visit_current_year(home_health_care,claim9,V1509)),1),V1510) +| | | | | Exit: evaluate(plus(countofall(V1512,visit_current_year(home_health_care,claim9,V1512)),1),1) +| | | | | Call: leq(1,100) +| | | | | Exit: leq(1,100) +| | | | Exit: check_policy_year_limit(C,Service) +| | | | Call: claim.location(claim9,V1513) +| | | | Exit: claim.location(claim9,home) +| | | | Call: valid_location(home_health_care,home) +| | | | Exit: valid_location(home_health_care,home) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim9,policy1) +Call: exception(claim9,policy1) +| Call: claim.claimant(claim9,V1514) +| Exit: claim.claimant(claim9,person5) +| Call: person.occupation(person5,armed_forces) +| Fail: person.occupation(person5,armed_forces) +| Redo: claim.claimant(claim9,V1514) +| Fail: claim.claimant(claim9,V1514) +| Call: claim.reason(claim9,home_health_care) +| Exit: claim.reason(claim9,home_health_care) +| Call: home_not_covered_list(V1515) +| Exit: home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Call: claim.home_service(claim9,V1516) +| Exit: claim.home_service(claim9,transportation) +| Call: member(transportation,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Exit: member(transportation,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +Exit: exception(C,P) +| | | Fail: ~exception(claim9,policy1) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(home_health_care,home) +| | | | Fail: valid_location(home_health_care,home) +| | | | Redo: claim.location(claim9,V1513) +| | | | Fail: claim.location(claim9,V1513) +| | | | Redo: check_policy_year_limit(C,Service) +| | | | | Redo: yearly_visit_limit(Service,Age,Limit) +| | | | | | Redo: yearly_visit_limit(home_health_care,V1506,V1507,V1505) +| | | | | | Fail: yearly_visit_limit(home_health_care,V1506,V1507,V1505) +| | | | | Fail: yearly_visit_limit(home_health_care,17,V1505) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_02_2024,01_01_2007,V1494) +| | | | | Redo: claim.time(claim9,V1492,V1493) +| | | | | Fail: claim.time(claim9,V1492,V1493) +| | | | | Redo: person.dob(person5,V1491) +| | | | | Fail: person.dob(person5,V1491) +| | | | | Redo: claim.claimant(claim9,V1490) +| | | | | Fail: claim.claimant(claim9,V1490) +| | | | Fail: check_policy_year_limit(claim9,home_health_care) +| | | | Call: covered_list_with_location(V1517) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Exit: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: claim.location(claim9,V1518) +| | | | Exit: claim.location(claim9,home) +| | | | Call: valid_location(home_health_care,home) +| | | | Exit: valid_location(home_health_care,home) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim9,policy1) +Call: exception(claim9,policy1) +| Call: claim.claimant(claim9,V1519) +| Exit: claim.claimant(claim9,person5) +| Call: person.occupation(person5,armed_forces) +| Fail: person.occupation(person5,armed_forces) +| Redo: claim.claimant(claim9,V1519) +| Fail: claim.claimant(claim9,V1519) +| Call: claim.reason(claim9,home_health_care) +| Exit: claim.reason(claim9,home_health_care) +| Call: home_not_covered_list(V1520) +| Exit: home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Call: claim.home_service(claim9,V1521) +| Exit: claim.home_service(claim9,transportation) +| Call: member(transportation,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Exit: member(transportation,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +Exit: exception(C,P) +| | | Fail: ~exception(claim9,policy1) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(home_health_care,home) +| | | | Fail: valid_location(home_health_care,home) +| | | | Redo: claim.location(claim9,V1518) +| | | | Fail: claim.location(claim9,V1518) +| | | | Redo: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1517) +| | | | Fail: covered_list_with_location(V1517) +| | | | Call: covered_list_with_service_provider(V1522) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(home_health_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(home_health_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1522) +| | | | Fail: covered_list_with_service_provider(V1522) +| | | | Call: covered_list(V1523) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(home_health_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(home_health_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1523) +| | | | Fail: covered_list(V1523) +| | | Fail: eligible_service(claim9,policy1,home_health_care) +| | | Redo: claim.reason(claim9,V1489) +| | | Fail: claim.reason(claim9,V1489) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim9,V1488) +| | | Fail: claim.hospital(claim9,V1488) +| | | Call: claim.reason(claim9,emergency_room) +| | | Fail: claim.reason(claim9,emergency_room) +| | Fail: valid_hospitalization(claim9,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1484) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1480) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_08_2023,V1476) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_08_2023,V1472) +| | | Redo: policy.enddate(policy1,person5,V1471) +| | | Fail: policy.enddate(policy1,person5,V1471) +| | | Redo: policy.startdate(policy1,person5,V1470) +| | | Fail: policy.startdate(policy1,person5,V1470) +| | | Redo: claim.hosp_end_time(claim9,V1468,V1469) +| | | Fail: claim.hosp_end_time(claim9,V1468,V1469) +| | | Redo: claim.hosp_start_time(claim9,V1466,V1467) +| | | Fail: claim.hosp_start_time(claim9,V1466,V1467) +| | | Redo: claim.claimant(claim9,V1465) +| | | Fail: claim.claimant(claim9,V1465) +| | Fail: policy_active(claim9,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person5) +| | | Fail: policy.insuree(policy1,person5) +| | | Redo: claim.claimant(claim9,V1464) +| | | Fail: claim.claimant(claim9,V1464) +| | Fail: valid_insuree(claim9,policy1) +| Fail: covered_under_policy(claim9,policy1,cardinal) +| Redo: policy.type(policy1,V1373) +| Fail: policy.type(policy1,V1373) +| Redo: claim.policy(X,V1372) +| Exit: claim.policy(claim10,policy1) +| Call: policy.type(policy1,V1373) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim10,policy1,cardinal) +| | Call: valid_insuree(claim10,policy1) +| | | Call: claim.claimant(claim10,V1524) +| | | Exit: claim.claimant(claim10,person5) +| | | Call: policy.insuree(policy1,person5) +| | | Exit: policy.insuree(policy1,person5) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim10,policy1) +| | | Call: claim.claimant(claim10,V1525) +| | | Exit: claim.claimant(claim10,person5) +| | | Call: claim.hosp_start_time(claim10,V1526,V1527) +| | | Exit: claim.hosp_start_time(claim10,02_08_2023,00_00) +| | | Call: claim.hosp_end_time(claim10,V1528,V1529) +| | | Exit: claim.hosp_end_time(claim10,02_08_2023,01_13) +| | | Call: policy.startdate(policy1,person5,V1530) +| | | Exit: policy.startdate(policy1,person5,01_08_2023) +| | | Call: policy.enddate(policy1,person5,V1531) +| | | Exit: policy.enddate(policy1,person5,30_06_2024) +| | | Call: get_timestamp_from_date(02_08_2023,V1532) +| | | | Call: evaluate(parsedate(02_08_2023),[V1533,V1534,V1535]) +| | | | Exit: evaluate(parsedate(02_08_2023),[02,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V1532) +| | | | Exit: evaluate(maketimestamp(2023,08,02,0,0,0),1690959600000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_08_2023,V1536) +| | | | Call: evaluate(parsedate(02_08_2023),[V1537,V1538,V1539]) +| | | | Exit: evaluate(parsedate(02_08_2023),[02,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V1536) +| | | | Exit: evaluate(maketimestamp(2023,08,02,0,0,0),1690959600000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1540) +| | | | Call: evaluate(parsedate(30_06_2024),[V1541,V1542,V1543]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1540) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1544) +| | | | Call: evaluate(parsedate(01_08_2023),[V1545,V1546,V1547]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1544) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1690959600000) +| | | Exit: leq(1690873200000,1690959600000) +| | | Call: leq(1690959600000,1719730800000) +| | | Exit: leq(1690959600000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim10,policy1) +| | | Call: claim.hospital(claim10,V1548) +| | | Exit: claim.hospital(claim10,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim10,V1549) +| | | Exit: claim.reason(claim10,home_health_care) +| | | Call: eligible_service(claim10,policy1,home_health_care) +| | | | Call: check_policy_year_limit(claim10,home_health_care) +| | | | | Call: claim.claimant(claim10,V1550) +| | | | | Exit: claim.claimant(claim10,person5) +| | | | | Call: person.dob(person5,V1551) +| | | | | Exit: person.dob(person5,01_01_2007) +| | | | | Call: claim.time(claim10,V1552,V1553) +| | | | | Exit: claim.time(claim10,01_02_2024,00_00) +| | | | | Call: get_date_diff(01_02_2024,01_01_2007,V1554) +| | | | | | Call: evaluate(parsedate(01_02_2024),[V1555,V1556,V1557]) +| | | | | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2007),[V1558,V1559,V1560]) +| | | | | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | | | | Call: evaluate(minus(2024,2007),V1561) +| | | | | | Exit: evaluate(minus(2024,2007),17) +| | | | | | Call: evaluate(minus(02,01),V1562) +| | | | | | Exit: evaluate(minus(02,01),1) +| | | | | | Call: evaluate(minus(01,01),V1563) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,1),0),V1564) +| | | | | | Exit: evaluate(plus(imul(31,1),0),31) +| | | | | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1554) +| | | | | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(home_health_care,17,V1565) +| | | | | | Call: yearly_visit_limit(home_health_care,V1566,V1567,V1565) +| | | | | | Exit: yearly_visit_limit(home_health_care,0,200,100) +| | | | | | Call: evaluate(minus(200,1),V1568) +| | | | | | Exit: evaluate(minus(200,1),199) +| | | | | | Call: leq(17,199) +| | | | | | Exit: leq(17,199) +| | | | | | Call: leq(0,17) +| | | | | | Exit: leq(0,17) +| | | | | Exit: yearly_visit_limit(Service,Age,Limit) +| | | | | Call: evaluate(plus(countofall(V1569,visit_current_year(home_health_care,claim10,V1569)),1),V1570) +| | | | | Exit: evaluate(plus(countofall(V1572,visit_current_year(home_health_care,claim10,V1572)),1),1) +| | | | | Call: leq(1,100) +| | | | | Exit: leq(1,100) +| | | | Exit: check_policy_year_limit(C,Service) +| | | | Call: claim.location(claim10,V1573) +| | | | Exit: claim.location(claim10,home) +| | | | Call: valid_location(home_health_care,home) +| | | | Exit: valid_location(home_health_care,home) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim10,policy1) +Call: exception(claim10,policy1) +| Call: claim.claimant(claim10,V1574) +| Exit: claim.claimant(claim10,person5) +| Call: person.occupation(person5,armed_forces) +| Fail: person.occupation(person5,armed_forces) +| Redo: claim.claimant(claim10,V1574) +| Fail: claim.claimant(claim10,V1574) +| Call: claim.reason(claim10,home_health_care) +| Exit: claim.reason(claim10,home_health_care) +| Call: home_not_covered_list(V1575) +| Exit: home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Call: claim.home_service(claim10,V1576) +| Exit: claim.home_service(claim10,other) +| Call: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Fail: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Redo: claim.home_service(claim10,V1576) +| Fail: claim.home_service(claim10,V1576) +| Redo: home_not_covered_list(V1575) +| Fail: home_not_covered_list(V1575) +| Redo: claim.reason(claim10,home_health_care) +| Fail: claim.reason(claim10,home_health_care) +| Call: claim.reason(claim10,home_health_care) +| Exit: claim.reason(claim10,home_health_care) +| Call: claim.claimant(claim10,V1577) +| Exit: claim.claimant(claim10,person5) +| Call: minor_or_dependent(claim10,person5) +| | Call: person.dependent(person5,yes) +| | Fail: person.dependent(person5,yes) +| | Call: person.dob(person5,V1578) +| | Exit: person.dob(person5,01_01_2007) +| | Call: claim.time(claim10,V1579,V1580) +| | Exit: claim.time(claim10,01_02_2024,00_00) +| | Call: get_date_diff(01_02_2024,01_01_2007,V1581) +| | | Call: evaluate(parsedate(01_02_2024),[V1582,V1583,V1584]) +| | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | Call: evaluate(parsedate(01_01_2007),[V1585,V1586,V1587]) +| | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | Call: evaluate(minus(2024,2007),V1588) +| | | Exit: evaluate(minus(2024,2007),17) +| | | Call: evaluate(minus(02,01),V1589) +| | | Exit: evaluate(minus(02,01),1) +| | | Call: evaluate(minus(01,01),V1590) +| | | Exit: evaluate(minus(01,01),0) +| | | Call: evaluate(plus(imul(31,1),0),V1591) +| | | Exit: evaluate(plus(imul(31,1),0),31) +| | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1581) +| | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | Exit: get_date_diff(C_D,DOB,Age) +| | Call: leq(17,17) +| | Exit: leq(17,17) +| Exit: minor_or_dependent(C,Cl) +| Call: claim.family_member_present(claim10,no) +| Exit: claim.family_member_present(claim10,no) +Exit: exception(C,P) +| | | Fail: ~exception(claim10,policy1) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(home_health_care,home) +| | | | Fail: valid_location(home_health_care,home) +| | | | Redo: claim.location(claim10,V1573) +| | | | Fail: claim.location(claim10,V1573) +| | | | Redo: check_policy_year_limit(C,Service) +| | | | | Redo: yearly_visit_limit(Service,Age,Limit) +| | | | | | Redo: yearly_visit_limit(home_health_care,V1566,V1567,V1565) +| | | | | | Fail: yearly_visit_limit(home_health_care,V1566,V1567,V1565) +| | | | | Fail: yearly_visit_limit(home_health_care,17,V1565) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_02_2024,01_01_2007,V1554) +| | | | | Redo: claim.time(claim10,V1552,V1553) +| | | | | Fail: claim.time(claim10,V1552,V1553) +| | | | | Redo: person.dob(person5,V1551) +| | | | | Fail: person.dob(person5,V1551) +| | | | | Redo: claim.claimant(claim10,V1550) +| | | | | Fail: claim.claimant(claim10,V1550) +| | | | Fail: check_policy_year_limit(claim10,home_health_care) +| | | | Call: covered_list_with_location(V1592) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Exit: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: claim.location(claim10,V1593) +| | | | Exit: claim.location(claim10,home) +| | | | Call: valid_location(home_health_care,home) +| | | | Exit: valid_location(home_health_care,home) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim10,policy1) +Call: exception(claim10,policy1) +| Call: claim.claimant(claim10,V1594) +| Exit: claim.claimant(claim10,person5) +| Call: person.occupation(person5,armed_forces) +| Fail: person.occupation(person5,armed_forces) +| Redo: claim.claimant(claim10,V1594) +| Fail: claim.claimant(claim10,V1594) +| Call: claim.reason(claim10,home_health_care) +| Exit: claim.reason(claim10,home_health_care) +| Call: home_not_covered_list(V1595) +| Exit: home_not_covered_list([transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Call: claim.home_service(claim10,V1596) +| Exit: claim.home_service(claim10,other) +| Call: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Fail: member(other,[transportation,homemaker_service,home_delivery,maintenance_therapy]) +| Redo: claim.home_service(claim10,V1596) +| Fail: claim.home_service(claim10,V1596) +| Redo: home_not_covered_list(V1595) +| Fail: home_not_covered_list(V1595) +| Redo: claim.reason(claim10,home_health_care) +| Fail: claim.reason(claim10,home_health_care) +| Call: claim.reason(claim10,home_health_care) +| Exit: claim.reason(claim10,home_health_care) +| Call: claim.claimant(claim10,V1597) +| Exit: claim.claimant(claim10,person5) +| Call: minor_or_dependent(claim10,person5) +| | Call: person.dependent(person5,yes) +| | Fail: person.dependent(person5,yes) +| | Call: person.dob(person5,V1598) +| | Exit: person.dob(person5,01_01_2007) +| | Call: claim.time(claim10,V1599,V1600) +| | Exit: claim.time(claim10,01_02_2024,00_00) +| | Call: get_date_diff(01_02_2024,01_01_2007,V1601) +| | | Call: evaluate(parsedate(01_02_2024),[V1602,V1603,V1604]) +| | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) +| | | Call: evaluate(parsedate(01_01_2007),[V1605,V1606,V1607]) +| | | Exit: evaluate(parsedate(01_01_2007),[01,01,2007]) +| | | Call: evaluate(minus(2024,2007),V1608) +| | | Exit: evaluate(minus(2024,2007),17) +| | | Call: evaluate(minus(02,01),V1609) +| | | Exit: evaluate(minus(02,01),1) +| | | Call: evaluate(minus(01,01),V1610) +| | | Exit: evaluate(minus(01,01),0) +| | | Call: evaluate(plus(imul(31,1),0),V1611) +| | | Exit: evaluate(plus(imul(31,1),0),31) +| | | Call: evaluate(plus(17,if(leq(31,-1),-1,true,0)),V1601) +| | | Exit: evaluate(plus(17,if(leq(31,-1),-1,true,0)),17) +| | Exit: get_date_diff(C_D,DOB,Age) +| | Call: leq(17,17) +| | Exit: leq(17,17) +| Exit: minor_or_dependent(C,Cl) +| Call: claim.family_member_present(claim10,no) +| Exit: claim.family_member_present(claim10,no) +Exit: exception(C,P) +| | | Fail: ~exception(claim10,policy1) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(home_health_care,home) +| | | | Fail: valid_location(home_health_care,home) +| | | | Redo: claim.location(claim10,V1593) +| | | | Fail: claim.location(claim10,V1593) +| | | | Redo: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(home_health_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1592) +| | | | Fail: covered_list_with_location(V1592) +| | | | Call: covered_list_with_service_provider(V1612) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(home_health_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(home_health_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1612) +| | | | Fail: covered_list_with_service_provider(V1612) +| | | | Call: covered_list(V1613) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(home_health_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(home_health_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1613) +| | | | Fail: covered_list(V1613) +| | | Fail: eligible_service(claim10,policy1,home_health_care) +| | | Redo: claim.reason(claim10,V1549) +| | | Fail: claim.reason(claim10,V1549) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim10,V1548) +| | | Fail: claim.hospital(claim10,V1548) +| | | Call: claim.reason(claim10,emergency_room) +| | | Fail: claim.reason(claim10,emergency_room) +| | Fail: valid_hospitalization(claim10,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1544) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1540) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_08_2023,V1536) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_08_2023,V1532) +| | | Redo: policy.enddate(policy1,person5,V1531) +| | | Fail: policy.enddate(policy1,person5,V1531) +| | | Redo: policy.startdate(policy1,person5,V1530) +| | | Fail: policy.startdate(policy1,person5,V1530) +| | | Redo: claim.hosp_end_time(claim10,V1528,V1529) +| | | Fail: claim.hosp_end_time(claim10,V1528,V1529) +| | | Redo: claim.hosp_start_time(claim10,V1526,V1527) +| | | Fail: claim.hosp_start_time(claim10,V1526,V1527) +| | | Redo: claim.claimant(claim10,V1525) +| | | Fail: claim.claimant(claim10,V1525) +| | Fail: policy_active(claim10,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person5) +| | | Fail: policy.insuree(policy1,person5) +| | | Redo: claim.claimant(claim10,V1524) +| | | Fail: claim.claimant(claim10,V1524) +| | Fail: valid_insuree(claim10,policy1) +| Fail: covered_under_policy(claim10,policy1,cardinal) +| Redo: policy.type(policy1,V1373) +| Fail: policy.type(policy1,V1373) +| Redo: claim.policy(X,V1372) +| Fail: claim.policy(X,V1372) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_home_health_care.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim8' ] +RESULTS: [ 'claim8' ] +===== TEST SUCCEEDED: Test test_cases_home_health_care.hdf===== +Expected Result: [ 'claim_a1', 'claim_a2', 'claim_a3' ] +Call: covered(X) +| Call: claim.policy(X,V1614) +| Exit: claim.policy(claim_a1,policy1) +| Call: policy.type(policy1,V1615) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a1,policy1,cardinal) +| | Call: valid_insuree(claim_a1,policy1) +| | | Call: claim.claimant(claim_a1,V1616) +| | | Exit: claim.claimant(claim_a1,person_a1) +| | | Call: policy.insuree(policy1,person_a1) +| | | Exit: policy.insuree(policy1,person_a1) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a1,policy1) +| | | Call: claim.claimant(claim_a1,V1617) +| | | Exit: claim.claimant(claim_a1,person_a1) +| | | Call: claim.hosp_start_time(claim_a1,V1618,V1619) +| | | Exit: claim.hosp_start_time(claim_a1,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a1,V1620,V1621) +| | | Exit: claim.hosp_end_time(claim_a1,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a1,V1622) +| | | Exit: policy.startdate(policy1,person_a1,01_08_2023) +| | | Call: policy.enddate(policy1,person_a1,V1623) +| | | Exit: policy.enddate(policy1,person_a1,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1624) +| | | | Call: evaluate(parsedate(02_09_2023),[V1625,V1626,V1627]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1624) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1628) +| | | | Call: evaluate(parsedate(02_09_2023),[V1629,V1630,V1631]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1628) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1632) +| | | | Call: evaluate(parsedate(30_06_2024),[V1633,V1634,V1635]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1632) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1636) +| | | | Call: evaluate(parsedate(01_08_2023),[V1637,V1638,V1639]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1636) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a1,policy1) +| | | Call: claim.hospital(claim_a1,V1640) +| | | Exit: claim.hospital(claim_a1,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a1,V1641) +| | | Exit: claim.reason(claim_a1,hospice) +| | | Call: eligible_service(claim_a1,policy1,hospice) +| | | | Call: check_policy_year_limit(claim_a1,hospice) +| | | | | Call: claim.claimant(claim_a1,V1642) +| | | | | Exit: claim.claimant(claim_a1,person_a1) +| | | | | Call: person.dob(person_a1,V1643) +| | | | | Exit: person.dob(person_a1,01_01_2007) +| | | | | Call: claim.time(claim_a1,V1644,V1645) +| | | | | Fail: claim.time(claim_a1,V1644,V1645) +| | | | | Redo: person.dob(person_a1,V1643) +| | | | | Fail: person.dob(person_a1,V1643) +| | | | | Redo: claim.claimant(claim_a1,V1642) +| | | | | Fail: claim.claimant(claim_a1,V1642) +| | | | Fail: check_policy_year_limit(claim_a1,hospice) +| | | | Call: covered_list_with_location(V1646) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(hospice,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(hospice,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1646) +| | | | Fail: covered_list_with_location(V1646) +| | | | Call: covered_list_with_service_provider(V1647) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(hospice,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(hospice,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1647) +| | | | Fail: covered_list_with_service_provider(V1647) +| | | | Call: covered_list(V1648) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(hospice,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Exit: member(hospice,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a1,policy1) +Call: exception(claim_a1,policy1) +| Call: claim.claimant(claim_a1,V1649) +| Exit: claim.claimant(claim_a1,person_a1) +| Call: person.occupation(person_a1,armed_forces) +| Fail: person.occupation(person_a1,armed_forces) +| Redo: claim.claimant(claim_a1,V1649) +| Fail: claim.claimant(claim_a1,V1649) +| Call: claim.reason(claim_a1,home_health_care) +| Fail: claim.reason(claim_a1,home_health_care) +| Call: claim.reason(claim_a1,home_health_care) +| Fail: claim.reason(claim_a1,home_health_care) +Fail: exception(claim_a1,policy1) +| | | Exit: ~exception(claim_a1,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a1) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: member(hospice,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(hospice,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1648) +| | | | Fail: covered_list(V1648) +| | | Fail: eligible_service(claim_a1,policy1,hospice) +| | | Redo: claim.reason(claim_a1,V1641) +| | | Fail: claim.reason(claim_a1,V1641) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a1,V1640) +| | | Fail: claim.hospital(claim_a1,V1640) +| | | Call: claim.reason(claim_a1,emergency_room) +| | | Fail: claim.reason(claim_a1,emergency_room) +| | Fail: valid_hospitalization(claim_a1,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1636) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1632) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1628) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1624) +| | | Redo: policy.enddate(policy1,person_a1,V1623) +| | | Fail: policy.enddate(policy1,person_a1,V1623) +| | | Redo: policy.startdate(policy1,person_a1,V1622) +| | | Fail: policy.startdate(policy1,person_a1,V1622) +| | | Redo: claim.hosp_end_time(claim_a1,V1620,V1621) +| | | Fail: claim.hosp_end_time(claim_a1,V1620,V1621) +| | | Redo: claim.hosp_start_time(claim_a1,V1618,V1619) +| | | Fail: claim.hosp_start_time(claim_a1,V1618,V1619) +| | | Redo: claim.claimant(claim_a1,V1617) +| | | Fail: claim.claimant(claim_a1,V1617) +| | Fail: policy_active(claim_a1,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a1) +| | | Fail: policy.insuree(policy1,person_a1) +| | | Redo: claim.claimant(claim_a1,V1616) +| | | Fail: claim.claimant(claim_a1,V1616) +| | Fail: valid_insuree(claim_a1,policy1) +| Fail: covered_under_policy(claim_a1,policy1,cardinal) +| Redo: policy.type(policy1,V1615) +| Fail: policy.type(policy1,V1615) +| Redo: claim.policy(X,V1614) +| Exit: claim.policy(claim_a2,policy1) +| Call: policy.type(policy1,V1615) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a2,policy1,cardinal) +| | Call: valid_insuree(claim_a2,policy1) +| | | Call: claim.claimant(claim_a2,V1650) +| | | Exit: claim.claimant(claim_a2,person_a2) +| | | Call: policy.insuree(policy1,person_a2) +| | | Exit: policy.insuree(policy1,person_a2) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a2,policy1) +| | | Call: claim.claimant(claim_a2,V1651) +| | | Exit: claim.claimant(claim_a2,person_a2) +| | | Call: claim.hosp_start_time(claim_a2,V1652,V1653) +| | | Exit: claim.hosp_start_time(claim_a2,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a2,V1654,V1655) +| | | Exit: claim.hosp_end_time(claim_a2,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a2,V1656) +| | | Exit: policy.startdate(policy1,person_a2,01_08_2023) +| | | Call: policy.enddate(policy1,person_a2,V1657) +| | | Exit: policy.enddate(policy1,person_a2,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1658) +| | | | Call: evaluate(parsedate(02_09_2023),[V1659,V1660,V1661]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1658) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1662) +| | | | Call: evaluate(parsedate(02_09_2023),[V1663,V1664,V1665]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1662) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1666) +| | | | Call: evaluate(parsedate(30_06_2024),[V1667,V1668,V1669]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1666) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1670) +| | | | Call: evaluate(parsedate(01_08_2023),[V1671,V1672,V1673]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1670) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a2,policy1) +| | | Call: claim.hospital(claim_a2,V1674) +| | | Exit: claim.hospital(claim_a2,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim_a2,V1675) +| | | Exit: claim.reason(claim_a2,skilled_nursing) +| | | Call: eligible_service(claim_a2,policy1,skilled_nursing) +| | | | Call: check_policy_year_limit(claim_a2,skilled_nursing) +| | | | | Call: claim.claimant(claim_a2,V1676) +| | | | | Exit: claim.claimant(claim_a2,person_a2) +| | | | | Call: person.dob(person_a2,V1677) +| | | | | Exit: person.dob(person_a2,01_01_2007) +| | | | | Call: claim.time(claim_a2,V1678,V1679) +| | | | | Fail: claim.time(claim_a2,V1678,V1679) +| | | | | Redo: person.dob(person_a2,V1677) +| | | | | Fail: person.dob(person_a2,V1677) +| | | | | Redo: claim.claimant(claim_a2,V1676) +| | | | | Fail: claim.claimant(claim_a2,V1676) +| | | | Fail: check_policy_year_limit(claim_a2,skilled_nursing) +| | | | Call: covered_list_with_location(V1680) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(skilled_nursing,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(skilled_nursing,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1680) +| | | | Fail: covered_list_with_location(V1680) +| | | | Call: covered_list_with_service_provider(V1681) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(skilled_nursing,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(skilled_nursing,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1681) +| | | | Fail: covered_list_with_service_provider(V1681) +| | | | Call: covered_list(V1682) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(skilled_nursing,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Exit: member(skilled_nursing,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a2,policy1) +Call: exception(claim_a2,policy1) +| Call: claim.claimant(claim_a2,V1683) +| Exit: claim.claimant(claim_a2,person_a2) +| Call: person.occupation(person_a2,armed_forces) +| Fail: person.occupation(person_a2,armed_forces) +| Redo: claim.claimant(claim_a2,V1683) +| Fail: claim.claimant(claim_a2,V1683) +| Call: claim.reason(claim_a2,home_health_care) +| Fail: claim.reason(claim_a2,home_health_care) +| Call: claim.reason(claim_a2,home_health_care) +| Fail: claim.reason(claim_a2,home_health_care) +Fail: exception(claim_a2,policy1) +| | | Exit: ~exception(claim_a2,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a2) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: member(skilled_nursing,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Exit: member(skilled_nursing,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim_a2,policy1) +Call: exception(claim_a2,policy1) +| Call: claim.claimant(claim_a2,V1684) +| Exit: claim.claimant(claim_a2,person_a2) +| Call: person.occupation(person_a2,armed_forces) +| Fail: person.occupation(person_a2,armed_forces) +| Redo: claim.claimant(claim_a2,V1684) +| Fail: claim.claimant(claim_a2,V1684) +| Call: claim.reason(claim_a2,home_health_care) +| Fail: claim.reason(claim_a2,home_health_care) +| Call: claim.reason(claim_a2,home_health_care) +| Fail: claim.reason(claim_a2,home_health_care) +Fail: exception(claim_a2,policy1) +| | | Exit: ~exception(claim_a2,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a2) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: member(skilled_nursing,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(skilled_nursing,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1682) +| | | | Fail: covered_list(V1682) +| | | Fail: eligible_service(claim_a2,policy1,skilled_nursing) +| | | Redo: claim.reason(claim_a2,V1675) +| | | Fail: claim.reason(claim_a2,V1675) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim_a2,V1674) +| | | Fail: claim.hospital(claim_a2,V1674) +| | | Call: claim.reason(claim_a2,emergency_room) +| | | Fail: claim.reason(claim_a2,emergency_room) +| | Fail: valid_hospitalization(claim_a2,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1670) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1666) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1662) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1658) +| | | Redo: policy.enddate(policy1,person_a2,V1657) +| | | Fail: policy.enddate(policy1,person_a2,V1657) +| | | Redo: policy.startdate(policy1,person_a2,V1656) +| | | Fail: policy.startdate(policy1,person_a2,V1656) +| | | Redo: claim.hosp_end_time(claim_a2,V1654,V1655) +| | | Fail: claim.hosp_end_time(claim_a2,V1654,V1655) +| | | Redo: claim.hosp_start_time(claim_a2,V1652,V1653) +| | | Fail: claim.hosp_start_time(claim_a2,V1652,V1653) +| | | Redo: claim.claimant(claim_a2,V1651) +| | | Fail: claim.claimant(claim_a2,V1651) +| | Fail: policy_active(claim_a2,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a2) +| | | Fail: policy.insuree(policy1,person_a2) +| | | Redo: claim.claimant(claim_a2,V1650) +| | | Fail: claim.claimant(claim_a2,V1650) +| | Fail: valid_insuree(claim_a2,policy1) +| Fail: covered_under_policy(claim_a2,policy1,cardinal) +| Redo: policy.type(policy1,V1615) +| Fail: policy.type(policy1,V1615) +| Redo: claim.policy(X,V1614) +| Exit: claim.policy(claim_a3,policy1) +| Call: policy.type(policy1,V1615) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim_a3,policy1,cardinal) +| | Call: valid_insuree(claim_a3,policy1) +| | | Call: claim.claimant(claim_a3,V1685) +| | | Exit: claim.claimant(claim_a3,person_a3) +| | | Call: policy.insuree(policy1,person_a3) +| | | Exit: policy.insuree(policy1,person_a3) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim_a3,policy1) +| | | Call: claim.claimant(claim_a3,V1686) +| | | Exit: claim.claimant(claim_a3,person_a3) +| | | Call: claim.hosp_start_time(claim_a3,V1687,V1688) +| | | Exit: claim.hosp_start_time(claim_a3,03_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim_a3,V1689,V1690) +| | | Exit: claim.hosp_end_time(claim_a3,03_09_2023,01_13) +| | | Call: policy.startdate(policy1,person_a3,V1691) +| | | Exit: policy.startdate(policy1,person_a3,01_08_2023) +| | | Call: policy.enddate(policy1,person_a3,V1692) +| | | Exit: policy.enddate(policy1,person_a3,30_06_2024) +| | | Call: get_timestamp_from_date(03_09_2023,V1693) +| | | | Call: evaluate(parsedate(03_09_2023),[V1694,V1695,V1696]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1693) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(03_09_2023,V1697) +| | | | Call: evaluate(parsedate(03_09_2023),[V1698,V1699,V1700]) +| | | | Exit: evaluate(parsedate(03_09_2023),[03,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,03,0,0,0),V1697) +| | | | Exit: evaluate(maketimestamp(2023,09,03,0,0,0),1693724400000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1701) +| | | | Call: evaluate(parsedate(30_06_2024),[V1702,V1703,V1704]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1701) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1705) +| | | | Call: evaluate(parsedate(01_08_2023),[V1706,V1707,V1708]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1705) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693724400000) +| | | Exit: leq(1690873200000,1693724400000) +| | | Call: leq(1693724400000,1719730800000) +| | | Exit: leq(1693724400000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim_a3,policy1) +| | | Call: claim.hospital(claim_a3,V1709) +| | | Exit: claim.hospital(claim_a3,other) +| | | Call: valid_hospital(other) +| | | Fail: valid_hospital(other) +| | | Redo: claim.hospital(claim_a3,V1709) +| | | Fail: claim.hospital(claim_a3,V1709) +| | | Call: claim.reason(claim_a3,emergency_room) +| | | Exit: claim.reason(claim_a3,emergency_room) +| | | Call: claim.type_of_care(claim_a3,emergency) +| | | Exit: claim.type_of_care(claim_a3,emergency) +| | | Call: ~exception(claim_a3,policy1) +Call: exception(claim_a3,policy1) +| Call: claim.claimant(claim_a3,V1710) +| Exit: claim.claimant(claim_a3,person_a3) +| Call: person.occupation(person_a3,armed_forces) +| Fail: person.occupation(person_a3,armed_forces) +| Redo: claim.claimant(claim_a3,V1710) +| Fail: claim.claimant(claim_a3,V1710) +| Call: claim.reason(claim_a3,home_health_care) +| Fail: claim.reason(claim_a3,home_health_care) +| Call: claim.reason(claim_a3,home_health_care) +| Fail: claim.reason(claim_a3,home_health_care) +Fail: exception(claim_a3,policy1) +| | | Exit: ~exception(claim_a3,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim_a3) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: claim.type_of_care(claim_a3,emergency) +| | | Fail: claim.type_of_care(claim_a3,emergency) +| | | Redo: claim.reason(claim_a3,emergency_room) +| | | Fail: claim.reason(claim_a3,emergency_room) +| | Fail: valid_hospitalization(claim_a3,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1705) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1701) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1697) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(03_09_2023,V1693) +| | | Redo: policy.enddate(policy1,person_a3,V1692) +| | | Fail: policy.enddate(policy1,person_a3,V1692) +| | | Redo: policy.startdate(policy1,person_a3,V1691) +| | | Fail: policy.startdate(policy1,person_a3,V1691) +| | | Redo: claim.hosp_end_time(claim_a3,V1689,V1690) +| | | Fail: claim.hosp_end_time(claim_a3,V1689,V1690) +| | | Redo: claim.hosp_start_time(claim_a3,V1687,V1688) +| | | Fail: claim.hosp_start_time(claim_a3,V1687,V1688) +| | | Redo: claim.claimant(claim_a3,V1686) +| | | Fail: claim.claimant(claim_a3,V1686) +| | Fail: policy_active(claim_a3,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person_a3) +| | | Fail: policy.insuree(policy1,person_a3) +| | | Redo: claim.claimant(claim_a3,V1685) +| | | Fail: claim.claimant(claim_a3,V1685) +| | Fail: valid_insuree(claim_a3,policy1) +| Fail: covered_under_policy(claim_a3,policy1,cardinal) +| Redo: policy.type(policy1,V1615) +| Fail: policy.type(policy1,V1615) +| Redo: claim.policy(X,V1614) +| Fail: claim.policy(X,V1614) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_hospice_etc.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim_a1', 'claim_a2', 'claim_a3' ] +RESULTS: [ 'claim_a1', 'claim_a2', 'claim_a3' ] +===== TEST SUCCEEDED: Test test_cases_hospice_etc.hdf===== +Expected Result: [ 'claim5' ] +Call: covered(X) +| Call: claim.policy(X,V1711) +| Exit: claim.policy(claim5,policy1) +| Call: policy.type(policy1,V1712) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim5,policy1,cardinal) +| | Call: valid_insuree(claim5,policy1) +| | | Call: claim.claimant(claim5,V1713) +| | | Exit: claim.claimant(claim5,person3) +| | | Call: policy.insuree(policy1,person3) +| | | Exit: policy.insuree(policy1,person3) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim5,policy1) +| | | Call: claim.claimant(claim5,V1714) +| | | Exit: claim.claimant(claim5,person3) +| | | Call: claim.hosp_start_time(claim5,V1715,V1716) +| | | Exit: claim.hosp_start_time(claim5,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim5,V1717,V1718) +| | | Exit: claim.hosp_end_time(claim5,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person3,V1719) +| | | Exit: policy.startdate(policy1,person3,01_08_2023) +| | | Call: policy.enddate(policy1,person3,V1720) +| | | Exit: policy.enddate(policy1,person3,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1721) +| | | | Call: evaluate(parsedate(02_09_2023),[V1722,V1723,V1724]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1721) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1725) +| | | | Call: evaluate(parsedate(02_09_2023),[V1726,V1727,V1728]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1725) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1729) +| | | | Call: evaluate(parsedate(30_06_2024),[V1730,V1731,V1732]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1729) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1733) +| | | | Call: evaluate(parsedate(01_08_2023),[V1734,V1735,V1736]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1733) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim5,policy1) +| | | Call: claim.hospital(claim5,V1737) +| | | Exit: claim.hospital(claim5,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim5,V1738) +| | | Exit: claim.reason(claim5,inpatient_care) +| | | Call: eligible_service(claim5,policy1,inpatient_care) +| | | | Call: check_policy_year_limit(claim5,inpatient_care) +| | | | | Call: claim.claimant(claim5,V1739) +| | | | | Exit: claim.claimant(claim5,person3) +| | | | | Call: person.dob(person3,V1740) +| | | | | Exit: person.dob(person3,01_01_2001) +| | | | | Call: claim.time(claim5,V1741,V1742) +| | | | | Exit: claim.time(claim5,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1743) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1744,V1745,V1746]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1747,V1748,V1749]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1750) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1751) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1752) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1753) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1743) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(inpatient_care,23,V1754) +| | | | | | Call: yearly_visit_limit(inpatient_care,V1755,V1756,V1754) +| | | | | | Fail: yearly_visit_limit(inpatient_care,V1755,V1756,V1754) +| | | | | Fail: yearly_visit_limit(inpatient_care,23,V1754) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1743) +| | | | | Redo: claim.time(claim5,V1741,V1742) +| | | | | Fail: claim.time(claim5,V1741,V1742) +| | | | | Redo: person.dob(person3,V1740) +| | | | | Fail: person.dob(person3,V1740) +| | | | | Redo: claim.claimant(claim5,V1739) +| | | | | Fail: claim.claimant(claim5,V1739) +| | | | Fail: check_policy_year_limit(claim5,inpatient_care) +| | | | Call: covered_list_with_location(V1757) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Exit: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: claim.location(claim5,V1758) +| | | | Exit: claim.location(claim5,hospital) +| | | | Call: valid_location(inpatient_care,hospital) +| | | | Exit: valid_location(inpatient_care,hospital) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim5,policy1) +Call: exception(claim5,policy1) +| Call: claim.claimant(claim5,V1759) +| Exit: claim.claimant(claim5,person3) +| Call: person.occupation(person3,armed_forces) +| Fail: person.occupation(person3,armed_forces) +| Redo: claim.claimant(claim5,V1759) +| Fail: claim.claimant(claim5,V1759) +| Call: claim.reason(claim5,home_health_care) +| Fail: claim.reason(claim5,home_health_care) +| Call: claim.reason(claim5,home_health_care) +| Fail: claim.reason(claim5,home_health_care) +Fail: exception(claim5,policy1) +| | | Exit: ~exception(claim5,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim5) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(inpatient_care,hospital) +| | | | Fail: valid_location(inpatient_care,hospital) +| | | | Redo: claim.location(claim5,V1758) +| | | | Fail: claim.location(claim5,V1758) +| | | | Redo: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1757) +| | | | Fail: covered_list_with_location(V1757) +| | | | Call: covered_list_with_service_provider(V1760) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(inpatient_care,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(inpatient_care,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1760) +| | | | Fail: covered_list_with_service_provider(V1760) +| | | | Call: covered_list(V1761) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(inpatient_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(inpatient_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1761) +| | | | Fail: covered_list(V1761) +| | | Fail: eligible_service(claim5,policy1,inpatient_care) +| | | Redo: claim.reason(claim5,V1738) +| | | Fail: claim.reason(claim5,V1738) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim5,V1737) +| | | Fail: claim.hospital(claim5,V1737) +| | | Call: claim.reason(claim5,emergency_room) +| | | Fail: claim.reason(claim5,emergency_room) +| | Fail: valid_hospitalization(claim5,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1733) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1729) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1725) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1721) +| | | Redo: policy.enddate(policy1,person3,V1720) +| | | Fail: policy.enddate(policy1,person3,V1720) +| | | Redo: policy.startdate(policy1,person3,V1719) +| | | Fail: policy.startdate(policy1,person3,V1719) +| | | Redo: claim.hosp_end_time(claim5,V1717,V1718) +| | | Fail: claim.hosp_end_time(claim5,V1717,V1718) +| | | Redo: claim.hosp_start_time(claim5,V1715,V1716) +| | | Fail: claim.hosp_start_time(claim5,V1715,V1716) +| | | Redo: claim.claimant(claim5,V1714) +| | | Fail: claim.claimant(claim5,V1714) +| | Fail: policy_active(claim5,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person3) +| | | Fail: policy.insuree(policy1,person3) +| | | Redo: claim.claimant(claim5,V1713) +| | | Fail: claim.claimant(claim5,V1713) +| | Fail: valid_insuree(claim5,policy1) +| Fail: covered_under_policy(claim5,policy1,cardinal) +| Redo: policy.type(policy1,V1712) +| Fail: policy.type(policy1,V1712) +| Redo: claim.policy(X,V1711) +| Fail: claim.policy(X,V1711) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_inpatient_care.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim5' ] +RESULTS: [ 'claim5' ] +===== TEST SUCCEEDED: Test test_cases_inpatient_care.hdf===== +Expected Result: [ 'claim11' ] +Call: covered(X) +| Call: claim.policy(X,V1762) +| Exit: claim.policy(claim11,policy1) +| Call: policy.type(policy1,V1763) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim11,policy1,cardinal) +| | Call: valid_insuree(claim11,policy1) +| | | Call: claim.claimant(claim11,V1764) +| | | Exit: claim.claimant(claim11,person4) +| | | Call: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim11,policy1) +| | | Call: claim.claimant(claim11,V1765) +| | | Exit: claim.claimant(claim11,person4) +| | | Call: claim.hosp_start_time(claim11,V1766,V1767) +| | | Exit: claim.hosp_start_time(claim11,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim11,V1768,V1769) +| | | Exit: claim.hosp_end_time(claim11,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V1770) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V1771) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1772) +| | | | Call: evaluate(parsedate(02_09_2023),[V1773,V1774,V1775]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1772) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1776) +| | | | Call: evaluate(parsedate(02_09_2023),[V1777,V1778,V1779]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1776) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1780) +| | | | Call: evaluate(parsedate(30_06_2024),[V1781,V1782,V1783]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1780) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1784) +| | | | Call: evaluate(parsedate(01_08_2023),[V1785,V1786,V1787]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1784) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim11,policy1) +| | | Call: claim.hospital(claim11,V1788) +| | | Exit: claim.hospital(claim11,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim11,V1789) +| | | Exit: claim.reason(claim11,inpatient_surgical_services) +| | | Call: eligible_service(claim11,policy1,inpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim11,inpatient_surgical_services) +| | | | | Call: claim.claimant(claim11,V1790) +| | | | | Exit: claim.claimant(claim11,person4) +| | | | | Call: person.dob(person4,V1791) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim11,V1792,V1793) +| | | | | Exit: claim.time(claim11,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1794) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1795,V1796,V1797]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1798,V1799,V1800]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1801) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1802) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1803) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1804) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1794) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(inpatient_surgical_services,23,V1805) +| | | | | | Call: yearly_visit_limit(inpatient_surgical_services,V1806,V1807,V1805) +| | | | | | Fail: yearly_visit_limit(inpatient_surgical_services,V1806,V1807,V1805) +| | | | | Fail: yearly_visit_limit(inpatient_surgical_services,23,V1805) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1794) +| | | | | Redo: claim.time(claim11,V1792,V1793) +| | | | | Fail: claim.time(claim11,V1792,V1793) +| | | | | Redo: person.dob(person4,V1791) +| | | | | Fail: person.dob(person4,V1791) +| | | | | Redo: claim.claimant(claim11,V1790) +| | | | | Fail: claim.claimant(claim11,V1790) +| | | | Fail: check_policy_year_limit(claim11,inpatient_surgical_services) +| | | | Call: covered_list_with_location(V1808) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(inpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Exit: member(inpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: claim.location(claim11,V1809) +| | | | Exit: claim.location(claim11,birthing_center) +| | | | Call: valid_location(inpatient_surgical_services,birthing_center) +| | | | Exit: valid_location(inpatient_surgical_services,birthing_center) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim11,policy1) +Call: exception(claim11,policy1) +| Call: claim.claimant(claim11,V1810) +| Exit: claim.claimant(claim11,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim11,V1810) +| Fail: claim.claimant(claim11,V1810) +| Call: claim.reason(claim11,home_health_care) +| Fail: claim.reason(claim11,home_health_care) +| Call: claim.reason(claim11,home_health_care) +| Fail: claim.reason(claim11,home_health_care) +Fail: exception(claim11,policy1) +| | | Exit: ~exception(claim11,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim11) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(inpatient_surgical_services,birthing_center) +| | | | Fail: valid_location(inpatient_surgical_services,birthing_center) +| | | | Redo: claim.location(claim11,V1809) +| | | | Fail: claim.location(claim11,V1809) +| | | | Redo: member(inpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(inpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1808) +| | | | Fail: covered_list_with_location(V1808) +| | | | Call: covered_list_with_service_provider(V1811) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(inpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(inpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1811) +| | | | Fail: covered_list_with_service_provider(V1811) +| | | | Call: covered_list(V1812) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(inpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(inpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1812) +| | | | Fail: covered_list(V1812) +| | | | Call: claim.location(claim11,V1813) +| | | | Exit: claim.location(claim11,birthing_center) +| | | | Call: valid_location(inpatient_surgical_services,birthing_center) +| | | | Exit: valid_location(inpatient_surgical_services,birthing_center) +| | | | Call: claim.service_provider(claim11,V1814) +| | | | Exit: claim.service_provider(claim11,anesthetist) +| | | | Call: valid_service_provider(inpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(inpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim11,policy1) +Call: exception(claim11,policy1) +| Call: claim.claimant(claim11,V1815) +| Exit: claim.claimant(claim11,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim11,V1815) +| Fail: claim.claimant(claim11,V1815) +| Call: claim.reason(claim11,home_health_care) +| Fail: claim.reason(claim11,home_health_care) +| Call: claim.reason(claim11,home_health_care) +| Fail: claim.reason(claim11,home_health_care) +Fail: exception(claim11,policy1) +| | | Exit: ~exception(claim11,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim11) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(inpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(inpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim11,V1814) +| | | | Fail: claim.service_provider(claim11,V1814) +| | | | Redo: valid_location(inpatient_surgical_services,birthing_center) +| | | | Fail: valid_location(inpatient_surgical_services,birthing_center) +| | | | Redo: claim.location(claim11,V1813) +| | | | Fail: claim.location(claim11,V1813) +| | | Fail: eligible_service(claim11,policy1,inpatient_surgical_services) +| | | Redo: claim.reason(claim11,V1789) +| | | Fail: claim.reason(claim11,V1789) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim11,V1788) +| | | Fail: claim.hospital(claim11,V1788) +| | | Call: claim.reason(claim11,emergency_room) +| | | Fail: claim.reason(claim11,emergency_room) +| | Fail: valid_hospitalization(claim11,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1784) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1780) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1776) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1772) +| | | Redo: policy.enddate(policy1,person4,V1771) +| | | Fail: policy.enddate(policy1,person4,V1771) +| | | Redo: policy.startdate(policy1,person4,V1770) +| | | Fail: policy.startdate(policy1,person4,V1770) +| | | Redo: claim.hosp_end_time(claim11,V1768,V1769) +| | | Fail: claim.hosp_end_time(claim11,V1768,V1769) +| | | Redo: claim.hosp_start_time(claim11,V1766,V1767) +| | | Fail: claim.hosp_start_time(claim11,V1766,V1767) +| | | Redo: claim.claimant(claim11,V1765) +| | | Fail: claim.claimant(claim11,V1765) +| | Fail: policy_active(claim11,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Fail: policy.insuree(policy1,person4) +| | | Redo: claim.claimant(claim11,V1764) +| | | Fail: claim.claimant(claim11,V1764) +| | Fail: valid_insuree(claim11,policy1) +| Fail: covered_under_policy(claim11,policy1,cardinal) +| Redo: policy.type(policy1,V1763) +| Fail: policy.type(policy1,V1763) +| Redo: claim.policy(X,V1762) +| Fail: claim.policy(X,V1762) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_inpatient_surgical_services.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim11' ] +RESULTS: [ 'claim11' ] +===== TEST SUCCEEDED: Test test_cases_inpatient_surgical_services.hdf===== +Expected Result: [ 'claim6' ] +Call: covered(X) +| Call: claim.policy(X,V1816) +| Exit: claim.policy(claim6,policy1) +| Call: policy.type(policy1,V1817) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim6,policy1,cardinal) +| | Call: valid_insuree(claim6,policy1) +| | | Call: claim.claimant(claim6,V1818) +| | | Exit: claim.claimant(claim6,person4) +| | | Call: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim6,policy1) +| | | Call: claim.claimant(claim6,V1819) +| | | Exit: claim.claimant(claim6,person4) +| | | Call: claim.hosp_start_time(claim6,V1820,V1821) +| | | Exit: claim.hosp_start_time(claim6,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim6,V1822,V1823) +| | | Exit: claim.hosp_end_time(claim6,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V1824) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V1825) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1826) +| | | | Call: evaluate(parsedate(02_09_2023),[V1827,V1828,V1829]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1826) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1830) +| | | | Call: evaluate(parsedate(02_09_2023),[V1831,V1832,V1833]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1830) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1834) +| | | | Call: evaluate(parsedate(30_06_2024),[V1835,V1836,V1837]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1834) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1838) +| | | | Call: evaluate(parsedate(01_08_2023),[V1839,V1840,V1841]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1838) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim6,policy1) +| | | Call: claim.hospital(claim6,V1842) +| | | Exit: claim.hospital(claim6,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim6,V1843) +| | | Exit: claim.reason(claim6,outpatient_surgery_facility_charges) +| | | Call: eligible_service(claim6,policy1,outpatient_surgery_facility_charges) +| | | | Call: check_policy_year_limit(claim6,outpatient_surgery_facility_charges) +| | | | | Call: claim.claimant(claim6,V1844) +| | | | | Exit: claim.claimant(claim6,person4) +| | | | | Call: person.dob(person4,V1845) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim6,V1846,V1847) +| | | | | Fail: claim.time(claim6,V1846,V1847) +| | | | | Redo: person.dob(person4,V1845) +| | | | | Fail: person.dob(person4,V1845) +| | | | | Redo: claim.claimant(claim6,V1844) +| | | | | Fail: claim.claimant(claim6,V1844) +| | | | Fail: check_policy_year_limit(claim6,outpatient_surgery_facility_charges) +| | | | Call: covered_list_with_location(V1848) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgery_facility_charges,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgery_facility_charges,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1848) +| | | | Fail: covered_list_with_location(V1848) +| | | | Call: covered_list_with_service_provider(V1849) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgery_facility_charges,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgery_facility_charges,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1849) +| | | | Fail: covered_list_with_service_provider(V1849) +| | | | Call: covered_list(V1850) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgery_facility_charges,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgery_facility_charges,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1850) +| | | | Fail: covered_list(V1850) +| | | | Call: claim.location(claim6,V1851) +| | | | Exit: claim.location(claim6,outpatient_dept) +| | | | Call: valid_location(outpatient_surgery_facility_charges,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgery_facility_charges,outpatient_dept) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim6,policy1) +Call: exception(claim6,policy1) +| Call: claim.claimant(claim6,V1852) +| Exit: claim.claimant(claim6,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim6,V1852) +| Fail: claim.claimant(claim6,V1852) +| Call: claim.reason(claim6,home_health_care) +| Fail: claim.reason(claim6,home_health_care) +| Call: claim.reason(claim6,home_health_care) +| Fail: claim.reason(claim6,home_health_care) +Fail: exception(claim6,policy1) +| | | Exit: ~exception(claim6,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim6) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_location(outpatient_surgery_facility_charges,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgery_facility_charges,outpatient_dept) +| | | | Redo: claim.location(claim6,V1851) +| | | | Fail: claim.location(claim6,V1851) +| | | Fail: eligible_service(claim6,policy1,outpatient_surgery_facility_charges) +| | | Redo: claim.reason(claim6,V1843) +| | | Fail: claim.reason(claim6,V1843) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim6,V1842) +| | | Fail: claim.hospital(claim6,V1842) +| | | Call: claim.reason(claim6,emergency_room) +| | | Fail: claim.reason(claim6,emergency_room) +| | Fail: valid_hospitalization(claim6,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1838) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1834) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1830) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1826) +| | | Redo: policy.enddate(policy1,person4,V1825) +| | | Fail: policy.enddate(policy1,person4,V1825) +| | | Redo: policy.startdate(policy1,person4,V1824) +| | | Fail: policy.startdate(policy1,person4,V1824) +| | | Redo: claim.hosp_end_time(claim6,V1822,V1823) +| | | Fail: claim.hosp_end_time(claim6,V1822,V1823) +| | | Redo: claim.hosp_start_time(claim6,V1820,V1821) +| | | Fail: claim.hosp_start_time(claim6,V1820,V1821) +| | | Redo: claim.claimant(claim6,V1819) +| | | Fail: claim.claimant(claim6,V1819) +| | Fail: policy_active(claim6,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Fail: policy.insuree(policy1,person4) +| | | Redo: claim.claimant(claim6,V1818) +| | | Fail: claim.claimant(claim6,V1818) +| | Fail: valid_insuree(claim6,policy1) +| Fail: covered_under_policy(claim6,policy1,cardinal) +| Redo: policy.type(policy1,V1817) +| Fail: policy.type(policy1,V1817) +| Redo: claim.policy(X,V1816) +| Fail: claim.policy(X,V1816) +Fail: covered(X) +====== Verbose Output for test: Test test_cases_outpatient_surgery_facility_charges.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim6' ] +RESULTS: [ 'claim6' ] +===== TEST SUCCEEDED: Test test_cases_outpatient_surgery_facility_charges.hdf===== +Expected Result: [ 'claim12' ] +Call: covered(X) +| Call: claim.policy(X,V1853) +| Exit: claim.policy(claim12,policy1) +| Call: policy.type(policy1,V1854) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim12,policy1,cardinal) +| | Call: valid_insuree(claim12,policy1) +| | | Call: claim.claimant(claim12,V1855) +| | | Exit: claim.claimant(claim12,person4) +| | | Call: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim12,policy1) +| | | Call: claim.claimant(claim12,V1856) +| | | Exit: claim.claimant(claim12,person4) +| | | Call: claim.hosp_start_time(claim12,V1857,V1858) +| | | Exit: claim.hosp_start_time(claim12,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim12,V1859,V1860) +| | | Exit: claim.hosp_end_time(claim12,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V1861) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V1862) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1863) +| | | | Call: evaluate(parsedate(02_09_2023),[V1864,V1865,V1866]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1863) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1867) +| | | | Call: evaluate(parsedate(02_09_2023),[V1868,V1869,V1870]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1867) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1871) +| | | | Call: evaluate(parsedate(30_06_2024),[V1872,V1873,V1874]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1871) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1875) +| | | | Call: evaluate(parsedate(01_08_2023),[V1876,V1877,V1878]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1875) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V1879) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V1880) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V1881) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V1882) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V1883,V1884) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1885) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1886,V1887,V1888]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1889,V1890,V1891]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1892) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1893) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1894) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1895) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1885) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V1896) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V1897,V1898,V1896) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V1897,V1898,V1896) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V1896) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1885) +| | | | | Redo: claim.time(claim12,V1883,V1884) +| | | | | Fail: claim.time(claim12,V1883,V1884) +| | | | | Redo: person.dob(person4,V1882) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V1883,V1884) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1885) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1899,V1900,V1901]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1902,V1903,V1904]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1905) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1906) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1907) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1908) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1885) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V1896) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V1909,V1910,V1896) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V1909,V1910,V1896) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V1896) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1885) +| | | | | Redo: claim.time(claim12,V1883,V1884) +| | | | | Fail: claim.time(claim12,V1883,V1884) +| | | | | Redo: person.dob(person4,V1882) +| | | | | Fail: person.dob(person4,V1882) +| | | | | Redo: claim.claimant(claim12,V1881) +| | | | | Fail: claim.claimant(claim12,V1881) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V1911) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1911) +| | | | Fail: covered_list_with_location(V1911) +| | | | Call: covered_list_with_service_provider(V1912) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1912) +| | | | Fail: covered_list_with_service_provider(V1912) +| | | | Call: covered_list(V1913) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1913) +| | | | Fail: covered_list(V1913) +| | | | Call: claim.location(claim12,V1914) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V1915) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V1916) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V1916) +| Fail: claim.claimant(claim12,V1916) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V1915) +| | | | Fail: claim.service_provider(claim12,V1915) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V1914) +| | | | Fail: claim.location(claim12,V1914) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V1880) +| | | Fail: claim.reason(claim12,V1880) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V1879) +| | | Fail: claim.hospital(claim12,V1879) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1875) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1871) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1867) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1863) +| | | Redo: policy.enddate(policy1,person4,V1862) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1863) +| | | | Call: evaluate(parsedate(02_09_2023),[V1917,V1918,V1919]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1863) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1867) +| | | | Call: evaluate(parsedate(02_09_2023),[V1920,V1921,V1922]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1867) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1871) +| | | | Call: evaluate(parsedate(30_06_2024),[V1923,V1924,V1925]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1871) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1875) +| | | | Call: evaluate(parsedate(01_08_2023),[V1926,V1927,V1928]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1875) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V1929) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V1930) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V1931) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V1932) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V1933,V1934) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1935) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1936,V1937,V1938]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1939,V1940,V1941]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1942) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1943) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1944) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1945) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1935) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V1946) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V1947,V1948,V1946) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V1947,V1948,V1946) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V1946) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1935) +| | | | | Redo: claim.time(claim12,V1933,V1934) +| | | | | Fail: claim.time(claim12,V1933,V1934) +| | | | | Redo: person.dob(person4,V1932) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V1933,V1934) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1935) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1949,V1950,V1951]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1952,V1953,V1954]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1955) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1956) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1957) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1958) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1935) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V1946) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V1959,V1960,V1946) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V1959,V1960,V1946) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V1946) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1935) +| | | | | Redo: claim.time(claim12,V1933,V1934) +| | | | | Fail: claim.time(claim12,V1933,V1934) +| | | | | Redo: person.dob(person4,V1932) +| | | | | Fail: person.dob(person4,V1932) +| | | | | Redo: claim.claimant(claim12,V1931) +| | | | | Fail: claim.claimant(claim12,V1931) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V1961) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V1961) +| | | | Fail: covered_list_with_location(V1961) +| | | | Call: covered_list_with_service_provider(V1962) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V1962) +| | | | Fail: covered_list_with_service_provider(V1962) +| | | | Call: covered_list(V1963) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V1963) +| | | | Fail: covered_list(V1963) +| | | | Call: claim.location(claim12,V1964) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V1965) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V1966) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V1966) +| Fail: claim.claimant(claim12,V1966) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V1965) +| | | | Fail: claim.service_provider(claim12,V1965) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V1964) +| | | | Fail: claim.location(claim12,V1964) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V1930) +| | | Fail: claim.reason(claim12,V1930) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V1929) +| | | Fail: claim.hospital(claim12,V1929) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1875) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1871) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1867) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1863) +| | | Redo: policy.enddate(policy1,person4,V1862) +| | | Fail: policy.enddate(policy1,person4,V1862) +| | | Redo: policy.startdate(policy1,person4,V1861) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V1862) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1863) +| | | | Call: evaluate(parsedate(02_09_2023),[V1967,V1968,V1969]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1863) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1867) +| | | | Call: evaluate(parsedate(02_09_2023),[V1970,V1971,V1972]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1867) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1871) +| | | | Call: evaluate(parsedate(30_06_2024),[V1973,V1974,V1975]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1871) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1875) +| | | | Call: evaluate(parsedate(01_08_2023),[V1976,V1977,V1978]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1875) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V1979) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V1980) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V1981) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V1982) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V1983,V1984) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1985) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1986,V1987,V1988]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V1989,V1990,V1991]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V1992) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V1993) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V1994) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V1995) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1985) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V1996) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V1997,V1998,V1996) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V1997,V1998,V1996) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V1996) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1985) +| | | | | Redo: claim.time(claim12,V1983,V1984) +| | | | | Fail: claim.time(claim12,V1983,V1984) +| | | | | Redo: person.dob(person4,V1982) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V1983,V1984) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V1985) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V1999,V2000,V2001]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2002,V2003,V2004]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2005) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2006) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2007) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2008) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V1985) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V1996) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2009,V2010,V1996) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2009,V2010,V1996) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V1996) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V1985) +| | | | | Redo: claim.time(claim12,V1983,V1984) +| | | | | Fail: claim.time(claim12,V1983,V1984) +| | | | | Redo: person.dob(person4,V1982) +| | | | | Fail: person.dob(person4,V1982) +| | | | | Redo: claim.claimant(claim12,V1981) +| | | | | Fail: claim.claimant(claim12,V1981) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2011) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2011) +| | | | Fail: covered_list_with_location(V2011) +| | | | Call: covered_list_with_service_provider(V2012) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2012) +| | | | Fail: covered_list_with_service_provider(V2012) +| | | | Call: covered_list(V2013) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2013) +| | | | Fail: covered_list(V2013) +| | | | Call: claim.location(claim12,V2014) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2015) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2016) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2016) +| Fail: claim.claimant(claim12,V2016) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2015) +| | | | Fail: claim.service_provider(claim12,V2015) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2014) +| | | | Fail: claim.location(claim12,V2014) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V1980) +| | | Fail: claim.reason(claim12,V1980) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V1979) +| | | Fail: claim.hospital(claim12,V1979) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1875) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1871) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1867) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1863) +| | | Redo: policy.enddate(policy1,person4,V1862) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V1863) +| | | | Call: evaluate(parsedate(02_09_2023),[V2017,V2018,V2019]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1863) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V1867) +| | | | Call: evaluate(parsedate(02_09_2023),[V2020,V2021,V2022]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V1867) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V1871) +| | | | Call: evaluate(parsedate(30_06_2024),[V2023,V2024,V2025]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V1871) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V1875) +| | | | Call: evaluate(parsedate(01_08_2023),[V2026,V2027,V2028]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V1875) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2029) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2030) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2031) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2032) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2033,V2034) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2035) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2036,V2037,V2038]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2039,V2040,V2041]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2042) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2043) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2044) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2045) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2035) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2046) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2047,V2048,V2046) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2047,V2048,V2046) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2046) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2035) +| | | | | Redo: claim.time(claim12,V2033,V2034) +| | | | | Fail: claim.time(claim12,V2033,V2034) +| | | | | Redo: person.dob(person4,V2032) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2033,V2034) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2035) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2049,V2050,V2051]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2052,V2053,V2054]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2055) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2056) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2057) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2058) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2035) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2046) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2059,V2060,V2046) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2059,V2060,V2046) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2046) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2035) +| | | | | Redo: claim.time(claim12,V2033,V2034) +| | | | | Fail: claim.time(claim12,V2033,V2034) +| | | | | Redo: person.dob(person4,V2032) +| | | | | Fail: person.dob(person4,V2032) +| | | | | Redo: claim.claimant(claim12,V2031) +| | | | | Fail: claim.claimant(claim12,V2031) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2061) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2061) +| | | | Fail: covered_list_with_location(V2061) +| | | | Call: covered_list_with_service_provider(V2062) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2062) +| | | | Fail: covered_list_with_service_provider(V2062) +| | | | Call: covered_list(V2063) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2063) +| | | | Fail: covered_list(V2063) +| | | | Call: claim.location(claim12,V2064) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2065) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2066) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2066) +| Fail: claim.claimant(claim12,V2066) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2065) +| | | | Fail: claim.service_provider(claim12,V2065) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2064) +| | | | Fail: claim.location(claim12,V2064) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2030) +| | | Fail: claim.reason(claim12,V2030) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2029) +| | | Fail: claim.hospital(claim12,V2029) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V1875) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V1871) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1867) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V1863) +| | | Redo: policy.enddate(policy1,person4,V1862) +| | | Fail: policy.enddate(policy1,person4,V1862) +| | | Redo: policy.startdate(policy1,person4,V1861) +| | | Fail: policy.startdate(policy1,person4,V1861) +| | | Redo: claim.hosp_end_time(claim12,V1859,V1860) +| | | Fail: claim.hosp_end_time(claim12,V1859,V1860) +| | | Redo: claim.hosp_start_time(claim12,V1857,V1858) +| | | Fail: claim.hosp_start_time(claim12,V1857,V1858) +| | | Redo: claim.claimant(claim12,V1856) +| | | Fail: claim.claimant(claim12,V1856) +| | Fail: policy_active(claim12,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim12,policy1) +| | | Call: claim.claimant(claim12,V2067) +| | | Exit: claim.claimant(claim12,person4) +| | | Call: claim.hosp_start_time(claim12,V2068,V2069) +| | | Exit: claim.hosp_start_time(claim12,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim12,V2070,V2071) +| | | Exit: claim.hosp_end_time(claim12,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V2072) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2073) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2074) +| | | | Call: evaluate(parsedate(02_09_2023),[V2075,V2076,V2077]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2074) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2078) +| | | | Call: evaluate(parsedate(02_09_2023),[V2079,V2080,V2081]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2078) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2082) +| | | | Call: evaluate(parsedate(30_06_2024),[V2083,V2084,V2085]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2082) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2086) +| | | | Call: evaluate(parsedate(01_08_2023),[V2087,V2088,V2089]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2086) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2090) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2091) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2092) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2093) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2094,V2095) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2096) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2097,V2098,V2099]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2100,V2101,V2102]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2103) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2104) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2105) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2106) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2096) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2107) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2108,V2109,V2107) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2108,V2109,V2107) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2107) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2096) +| | | | | Redo: claim.time(claim12,V2094,V2095) +| | | | | Fail: claim.time(claim12,V2094,V2095) +| | | | | Redo: person.dob(person4,V2093) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2094,V2095) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2096) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2110,V2111,V2112]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2113,V2114,V2115]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2116) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2117) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2118) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2119) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2096) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2107) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2120,V2121,V2107) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2120,V2121,V2107) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2107) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2096) +| | | | | Redo: claim.time(claim12,V2094,V2095) +| | | | | Fail: claim.time(claim12,V2094,V2095) +| | | | | Redo: person.dob(person4,V2093) +| | | | | Fail: person.dob(person4,V2093) +| | | | | Redo: claim.claimant(claim12,V2092) +| | | | | Fail: claim.claimant(claim12,V2092) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2122) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2122) +| | | | Fail: covered_list_with_location(V2122) +| | | | Call: covered_list_with_service_provider(V2123) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2123) +| | | | Fail: covered_list_with_service_provider(V2123) +| | | | Call: covered_list(V2124) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2124) +| | | | Fail: covered_list(V2124) +| | | | Call: claim.location(claim12,V2125) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2126) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2127) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2127) +| Fail: claim.claimant(claim12,V2127) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2126) +| | | | Fail: claim.service_provider(claim12,V2126) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2125) +| | | | Fail: claim.location(claim12,V2125) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2091) +| | | Fail: claim.reason(claim12,V2091) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2090) +| | | Fail: claim.hospital(claim12,V2090) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2086) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2082) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2078) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2074) +| | | Redo: policy.enddate(policy1,person4,V2073) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2074) +| | | | Call: evaluate(parsedate(02_09_2023),[V2128,V2129,V2130]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2074) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2078) +| | | | Call: evaluate(parsedate(02_09_2023),[V2131,V2132,V2133]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2078) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2082) +| | | | Call: evaluate(parsedate(30_06_2024),[V2134,V2135,V2136]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2082) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2086) +| | | | Call: evaluate(parsedate(01_08_2023),[V2137,V2138,V2139]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2086) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2140) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2141) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2142) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2143) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2144,V2145) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2146) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2147,V2148,V2149]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2150,V2151,V2152]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2153) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2154) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2155) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2156) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2146) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2157) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2158,V2159,V2157) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2158,V2159,V2157) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2157) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2146) +| | | | | Redo: claim.time(claim12,V2144,V2145) +| | | | | Fail: claim.time(claim12,V2144,V2145) +| | | | | Redo: person.dob(person4,V2143) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2144,V2145) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2146) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2160,V2161,V2162]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2163,V2164,V2165]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2166) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2167) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2168) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2169) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2146) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2157) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2170,V2171,V2157) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2170,V2171,V2157) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2157) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2146) +| | | | | Redo: claim.time(claim12,V2144,V2145) +| | | | | Fail: claim.time(claim12,V2144,V2145) +| | | | | Redo: person.dob(person4,V2143) +| | | | | Fail: person.dob(person4,V2143) +| | | | | Redo: claim.claimant(claim12,V2142) +| | | | | Fail: claim.claimant(claim12,V2142) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2172) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2172) +| | | | Fail: covered_list_with_location(V2172) +| | | | Call: covered_list_with_service_provider(V2173) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2173) +| | | | Fail: covered_list_with_service_provider(V2173) +| | | | Call: covered_list(V2174) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2174) +| | | | Fail: covered_list(V2174) +| | | | Call: claim.location(claim12,V2175) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2176) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2177) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2177) +| Fail: claim.claimant(claim12,V2177) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2176) +| | | | Fail: claim.service_provider(claim12,V2176) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2175) +| | | | Fail: claim.location(claim12,V2175) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2141) +| | | Fail: claim.reason(claim12,V2141) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2140) +| | | Fail: claim.hospital(claim12,V2140) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2086) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2082) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2078) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2074) +| | | Redo: policy.enddate(policy1,person4,V2073) +| | | Fail: policy.enddate(policy1,person4,V2073) +| | | Redo: policy.startdate(policy1,person4,V2072) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2073) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2074) +| | | | Call: evaluate(parsedate(02_09_2023),[V2178,V2179,V2180]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2074) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2078) +| | | | Call: evaluate(parsedate(02_09_2023),[V2181,V2182,V2183]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2078) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2082) +| | | | Call: evaluate(parsedate(30_06_2024),[V2184,V2185,V2186]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2082) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2086) +| | | | Call: evaluate(parsedate(01_08_2023),[V2187,V2188,V2189]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2086) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2190) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2191) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2192) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2193) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2194,V2195) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2196) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2197,V2198,V2199]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2200,V2201,V2202]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2203) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2204) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2205) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2206) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2196) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2207) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2208,V2209,V2207) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2208,V2209,V2207) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2207) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2196) +| | | | | Redo: claim.time(claim12,V2194,V2195) +| | | | | Fail: claim.time(claim12,V2194,V2195) +| | | | | Redo: person.dob(person4,V2193) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2194,V2195) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2196) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2210,V2211,V2212]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2213,V2214,V2215]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2216) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2217) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2218) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2219) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2196) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2207) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2220,V2221,V2207) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2220,V2221,V2207) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2207) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2196) +| | | | | Redo: claim.time(claim12,V2194,V2195) +| | | | | Fail: claim.time(claim12,V2194,V2195) +| | | | | Redo: person.dob(person4,V2193) +| | | | | Fail: person.dob(person4,V2193) +| | | | | Redo: claim.claimant(claim12,V2192) +| | | | | Fail: claim.claimant(claim12,V2192) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2222) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2222) +| | | | Fail: covered_list_with_location(V2222) +| | | | Call: covered_list_with_service_provider(V2223) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2223) +| | | | Fail: covered_list_with_service_provider(V2223) +| | | | Call: covered_list(V2224) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2224) +| | | | Fail: covered_list(V2224) +| | | | Call: claim.location(claim12,V2225) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2226) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2227) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2227) +| Fail: claim.claimant(claim12,V2227) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2226) +| | | | Fail: claim.service_provider(claim12,V2226) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2225) +| | | | Fail: claim.location(claim12,V2225) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2191) +| | | Fail: claim.reason(claim12,V2191) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2190) +| | | Fail: claim.hospital(claim12,V2190) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2086) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2082) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2078) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2074) +| | | Redo: policy.enddate(policy1,person4,V2073) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2074) +| | | | Call: evaluate(parsedate(02_09_2023),[V2228,V2229,V2230]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2074) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2078) +| | | | Call: evaluate(parsedate(02_09_2023),[V2231,V2232,V2233]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2078) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2082) +| | | | Call: evaluate(parsedate(30_06_2024),[V2234,V2235,V2236]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2082) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2086) +| | | | Call: evaluate(parsedate(01_08_2023),[V2237,V2238,V2239]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2086) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2240) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2241) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2242) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2243) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2244,V2245) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2246) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2247,V2248,V2249]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2250,V2251,V2252]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2253) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2254) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2255) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2256) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2246) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2257) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2258,V2259,V2257) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2258,V2259,V2257) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2257) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2246) +| | | | | Redo: claim.time(claim12,V2244,V2245) +| | | | | Fail: claim.time(claim12,V2244,V2245) +| | | | | Redo: person.dob(person4,V2243) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2244,V2245) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2246) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2260,V2261,V2262]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2263,V2264,V2265]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2266) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2267) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2268) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2269) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2246) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2257) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2270,V2271,V2257) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2270,V2271,V2257) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2257) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2246) +| | | | | Redo: claim.time(claim12,V2244,V2245) +| | | | | Fail: claim.time(claim12,V2244,V2245) +| | | | | Redo: person.dob(person4,V2243) +| | | | | Fail: person.dob(person4,V2243) +| | | | | Redo: claim.claimant(claim12,V2242) +| | | | | Fail: claim.claimant(claim12,V2242) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2272) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2272) +| | | | Fail: covered_list_with_location(V2272) +| | | | Call: covered_list_with_service_provider(V2273) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2273) +| | | | Fail: covered_list_with_service_provider(V2273) +| | | | Call: covered_list(V2274) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2274) +| | | | Fail: covered_list(V2274) +| | | | Call: claim.location(claim12,V2275) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2276) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2277) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2277) +| Fail: claim.claimant(claim12,V2277) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2276) +| | | | Fail: claim.service_provider(claim12,V2276) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2275) +| | | | Fail: claim.location(claim12,V2275) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2241) +| | | Fail: claim.reason(claim12,V2241) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2240) +| | | Fail: claim.hospital(claim12,V2240) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2086) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2082) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2078) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2074) +| | | Redo: policy.enddate(policy1,person4,V2073) +| | | Fail: policy.enddate(policy1,person4,V2073) +| | | Redo: policy.startdate(policy1,person4,V2072) +| | | Fail: policy.startdate(policy1,person4,V2072) +| | | Redo: claim.hosp_end_time(claim12,V2070,V2071) +| | | Fail: claim.hosp_end_time(claim12,V2070,V2071) +| | | Redo: claim.hosp_start_time(claim12,V2068,V2069) +| | | Fail: claim.hosp_start_time(claim12,V2068,V2069) +| | | Redo: claim.claimant(claim12,V2067) +| | | Fail: claim.claimant(claim12,V2067) +| | Fail: policy_active(claim12,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Fail: policy.insuree(policy1,person4) +| | | Redo: claim.claimant(claim12,V1855) +| | | Fail: claim.claimant(claim12,V1855) +| | Fail: valid_insuree(claim12,policy1) +| Fail: covered_under_policy(claim12,policy1,cardinal) +| Redo: policy.type(policy1,V1854) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim12,policy1,cardinal) +| | Call: valid_insuree(claim12,policy1) +| | | Call: claim.claimant(claim12,V2278) +| | | Exit: claim.claimant(claim12,person4) +| | | Call: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim12,policy1) +| | | Call: claim.claimant(claim12,V2279) +| | | Exit: claim.claimant(claim12,person4) +| | | Call: claim.hosp_start_time(claim12,V2280,V2281) +| | | Exit: claim.hosp_start_time(claim12,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim12,V2282,V2283) +| | | Exit: claim.hosp_end_time(claim12,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V2284) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2285) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2286) +| | | | Call: evaluate(parsedate(02_09_2023),[V2287,V2288,V2289]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2286) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2290) +| | | | Call: evaluate(parsedate(02_09_2023),[V2291,V2292,V2293]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2290) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2294) +| | | | Call: evaluate(parsedate(30_06_2024),[V2295,V2296,V2297]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2294) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2298) +| | | | Call: evaluate(parsedate(01_08_2023),[V2299,V2300,V2301]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2298) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2302) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2303) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2304) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2305) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2306,V2307) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2308) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2309,V2310,V2311]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2312,V2313,V2314]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2315) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2316) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2317) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2318) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2308) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2319) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2320,V2321,V2319) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2320,V2321,V2319) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2319) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2308) +| | | | | Redo: claim.time(claim12,V2306,V2307) +| | | | | Fail: claim.time(claim12,V2306,V2307) +| | | | | Redo: person.dob(person4,V2305) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2306,V2307) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2308) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2322,V2323,V2324]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2325,V2326,V2327]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2328) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2329) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2330) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2331) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2308) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2319) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2332,V2333,V2319) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2332,V2333,V2319) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2319) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2308) +| | | | | Redo: claim.time(claim12,V2306,V2307) +| | | | | Fail: claim.time(claim12,V2306,V2307) +| | | | | Redo: person.dob(person4,V2305) +| | | | | Fail: person.dob(person4,V2305) +| | | | | Redo: claim.claimant(claim12,V2304) +| | | | | Fail: claim.claimant(claim12,V2304) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2334) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2334) +| | | | Fail: covered_list_with_location(V2334) +| | | | Call: covered_list_with_service_provider(V2335) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2335) +| | | | Fail: covered_list_with_service_provider(V2335) +| | | | Call: covered_list(V2336) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2336) +| | | | Fail: covered_list(V2336) +| | | | Call: claim.location(claim12,V2337) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2338) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2339) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2339) +| Fail: claim.claimant(claim12,V2339) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2338) +| | | | Fail: claim.service_provider(claim12,V2338) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2337) +| | | | Fail: claim.location(claim12,V2337) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2303) +| | | Fail: claim.reason(claim12,V2303) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2302) +| | | Fail: claim.hospital(claim12,V2302) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2298) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2294) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2290) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2286) +| | | Redo: policy.enddate(policy1,person4,V2285) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2286) +| | | | Call: evaluate(parsedate(02_09_2023),[V2340,V2341,V2342]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2286) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2290) +| | | | Call: evaluate(parsedate(02_09_2023),[V2343,V2344,V2345]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2290) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2294) +| | | | Call: evaluate(parsedate(30_06_2024),[V2346,V2347,V2348]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2294) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2298) +| | | | Call: evaluate(parsedate(01_08_2023),[V2349,V2350,V2351]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2298) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2352) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2353) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2354) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2355) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2356,V2357) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2358) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2359,V2360,V2361]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2362,V2363,V2364]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2365) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2366) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2367) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2368) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2358) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2369) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2370,V2371,V2369) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2370,V2371,V2369) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2369) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2358) +| | | | | Redo: claim.time(claim12,V2356,V2357) +| | | | | Fail: claim.time(claim12,V2356,V2357) +| | | | | Redo: person.dob(person4,V2355) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2356,V2357) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2358) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2372,V2373,V2374]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2375,V2376,V2377]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2378) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2379) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2380) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2381) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2358) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2369) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2382,V2383,V2369) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2382,V2383,V2369) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2369) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2358) +| | | | | Redo: claim.time(claim12,V2356,V2357) +| | | | | Fail: claim.time(claim12,V2356,V2357) +| | | | | Redo: person.dob(person4,V2355) +| | | | | Fail: person.dob(person4,V2355) +| | | | | Redo: claim.claimant(claim12,V2354) +| | | | | Fail: claim.claimant(claim12,V2354) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2384) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2384) +| | | | Fail: covered_list_with_location(V2384) +| | | | Call: covered_list_with_service_provider(V2385) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2385) +| | | | Fail: covered_list_with_service_provider(V2385) +| | | | Call: covered_list(V2386) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2386) +| | | | Fail: covered_list(V2386) +| | | | Call: claim.location(claim12,V2387) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2388) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2389) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2389) +| Fail: claim.claimant(claim12,V2389) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2388) +| | | | Fail: claim.service_provider(claim12,V2388) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2387) +| | | | Fail: claim.location(claim12,V2387) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2353) +| | | Fail: claim.reason(claim12,V2353) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2352) +| | | Fail: claim.hospital(claim12,V2352) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2298) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2294) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2290) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2286) +| | | Redo: policy.enddate(policy1,person4,V2285) +| | | Fail: policy.enddate(policy1,person4,V2285) +| | | Redo: policy.startdate(policy1,person4,V2284) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2285) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2286) +| | | | Call: evaluate(parsedate(02_09_2023),[V2390,V2391,V2392]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2286) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2290) +| | | | Call: evaluate(parsedate(02_09_2023),[V2393,V2394,V2395]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2290) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2294) +| | | | Call: evaluate(parsedate(30_06_2024),[V2396,V2397,V2398]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2294) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2298) +| | | | Call: evaluate(parsedate(01_08_2023),[V2399,V2400,V2401]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2298) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2402) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2403) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2404) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2405) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2406,V2407) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2408) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2409,V2410,V2411]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2412,V2413,V2414]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2415) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2416) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2417) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2418) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2408) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2419) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2420,V2421,V2419) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2420,V2421,V2419) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2419) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2408) +| | | | | Redo: claim.time(claim12,V2406,V2407) +| | | | | Fail: claim.time(claim12,V2406,V2407) +| | | | | Redo: person.dob(person4,V2405) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2406,V2407) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2408) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2422,V2423,V2424]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2425,V2426,V2427]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2428) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2429) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2430) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2431) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2408) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2419) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2432,V2433,V2419) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2432,V2433,V2419) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2419) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2408) +| | | | | Redo: claim.time(claim12,V2406,V2407) +| | | | | Fail: claim.time(claim12,V2406,V2407) +| | | | | Redo: person.dob(person4,V2405) +| | | | | Fail: person.dob(person4,V2405) +| | | | | Redo: claim.claimant(claim12,V2404) +| | | | | Fail: claim.claimant(claim12,V2404) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2434) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2434) +| | | | Fail: covered_list_with_location(V2434) +| | | | Call: covered_list_with_service_provider(V2435) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2435) +| | | | Fail: covered_list_with_service_provider(V2435) +| | | | Call: covered_list(V2436) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2436) +| | | | Fail: covered_list(V2436) +| | | | Call: claim.location(claim12,V2437) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2438) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2439) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2439) +| Fail: claim.claimant(claim12,V2439) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2438) +| | | | Fail: claim.service_provider(claim12,V2438) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2437) +| | | | Fail: claim.location(claim12,V2437) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2403) +| | | Fail: claim.reason(claim12,V2403) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2402) +| | | Fail: claim.hospital(claim12,V2402) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2298) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2294) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2290) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2286) +| | | Redo: policy.enddate(policy1,person4,V2285) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2286) +| | | | Call: evaluate(parsedate(02_09_2023),[V2440,V2441,V2442]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2286) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2290) +| | | | Call: evaluate(parsedate(02_09_2023),[V2443,V2444,V2445]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2290) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2294) +| | | | Call: evaluate(parsedate(30_06_2024),[V2446,V2447,V2448]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2294) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2298) +| | | | Call: evaluate(parsedate(01_08_2023),[V2449,V2450,V2451]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2298) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2452) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2453) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2454) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2455) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2456,V2457) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2458) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2459,V2460,V2461]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2462,V2463,V2464]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2465) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2466) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2467) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2468) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2458) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2469) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2470,V2471,V2469) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2470,V2471,V2469) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2469) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2458) +| | | | | Redo: claim.time(claim12,V2456,V2457) +| | | | | Fail: claim.time(claim12,V2456,V2457) +| | | | | Redo: person.dob(person4,V2455) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2456,V2457) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2458) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2472,V2473,V2474]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2475,V2476,V2477]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2478) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2479) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2480) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2481) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2458) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2469) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2482,V2483,V2469) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2482,V2483,V2469) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2469) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2458) +| | | | | Redo: claim.time(claim12,V2456,V2457) +| | | | | Fail: claim.time(claim12,V2456,V2457) +| | | | | Redo: person.dob(person4,V2455) +| | | | | Fail: person.dob(person4,V2455) +| | | | | Redo: claim.claimant(claim12,V2454) +| | | | | Fail: claim.claimant(claim12,V2454) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2484) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2484) +| | | | Fail: covered_list_with_location(V2484) +| | | | Call: covered_list_with_service_provider(V2485) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2485) +| | | | Fail: covered_list_with_service_provider(V2485) +| | | | Call: covered_list(V2486) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2486) +| | | | Fail: covered_list(V2486) +| | | | Call: claim.location(claim12,V2487) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2488) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2489) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2489) +| Fail: claim.claimant(claim12,V2489) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2488) +| | | | Fail: claim.service_provider(claim12,V2488) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2487) +| | | | Fail: claim.location(claim12,V2487) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2453) +| | | Fail: claim.reason(claim12,V2453) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2452) +| | | Fail: claim.hospital(claim12,V2452) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2298) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2294) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2290) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2286) +| | | Redo: policy.enddate(policy1,person4,V2285) +| | | Fail: policy.enddate(policy1,person4,V2285) +| | | Redo: policy.startdate(policy1,person4,V2284) +| | | Fail: policy.startdate(policy1,person4,V2284) +| | | Redo: claim.hosp_end_time(claim12,V2282,V2283) +| | | Fail: claim.hosp_end_time(claim12,V2282,V2283) +| | | Redo: claim.hosp_start_time(claim12,V2280,V2281) +| | | Fail: claim.hosp_start_time(claim12,V2280,V2281) +| | | Redo: claim.claimant(claim12,V2279) +| | | Fail: claim.claimant(claim12,V2279) +| | Fail: policy_active(claim12,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim12,policy1) +| | | Call: claim.claimant(claim12,V2490) +| | | Exit: claim.claimant(claim12,person4) +| | | Call: claim.hosp_start_time(claim12,V2491,V2492) +| | | Exit: claim.hosp_start_time(claim12,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim12,V2493,V2494) +| | | Exit: claim.hosp_end_time(claim12,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V2495) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2496) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2497) +| | | | Call: evaluate(parsedate(02_09_2023),[V2498,V2499,V2500]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2497) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2501) +| | | | Call: evaluate(parsedate(02_09_2023),[V2502,V2503,V2504]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2501) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2505) +| | | | Call: evaluate(parsedate(30_06_2024),[V2506,V2507,V2508]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2505) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2509) +| | | | Call: evaluate(parsedate(01_08_2023),[V2510,V2511,V2512]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2509) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2513) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2514) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2515) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2516) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2517,V2518) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2519) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2520,V2521,V2522]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2523,V2524,V2525]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2526) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2527) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2528) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2529) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2519) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2530) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2531,V2532,V2530) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2531,V2532,V2530) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2530) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2519) +| | | | | Redo: claim.time(claim12,V2517,V2518) +| | | | | Fail: claim.time(claim12,V2517,V2518) +| | | | | Redo: person.dob(person4,V2516) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2517,V2518) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2519) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2533,V2534,V2535]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2536,V2537,V2538]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2539) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2540) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2541) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2542) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2519) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2530) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2543,V2544,V2530) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2543,V2544,V2530) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2530) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2519) +| | | | | Redo: claim.time(claim12,V2517,V2518) +| | | | | Fail: claim.time(claim12,V2517,V2518) +| | | | | Redo: person.dob(person4,V2516) +| | | | | Fail: person.dob(person4,V2516) +| | | | | Redo: claim.claimant(claim12,V2515) +| | | | | Fail: claim.claimant(claim12,V2515) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2545) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2545) +| | | | Fail: covered_list_with_location(V2545) +| | | | Call: covered_list_with_service_provider(V2546) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2546) +| | | | Fail: covered_list_with_service_provider(V2546) +| | | | Call: covered_list(V2547) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2547) +| | | | Fail: covered_list(V2547) +| | | | Call: claim.location(claim12,V2548) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2549) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2550) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2550) +| Fail: claim.claimant(claim12,V2550) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2549) +| | | | Fail: claim.service_provider(claim12,V2549) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2548) +| | | | Fail: claim.location(claim12,V2548) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2514) +| | | Fail: claim.reason(claim12,V2514) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2513) +| | | Fail: claim.hospital(claim12,V2513) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2509) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2505) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2501) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2497) +| | | Redo: policy.enddate(policy1,person4,V2496) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2497) +| | | | Call: evaluate(parsedate(02_09_2023),[V2551,V2552,V2553]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2497) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2501) +| | | | Call: evaluate(parsedate(02_09_2023),[V2554,V2555,V2556]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2501) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2505) +| | | | Call: evaluate(parsedate(30_06_2024),[V2557,V2558,V2559]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2505) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2509) +| | | | Call: evaluate(parsedate(01_08_2023),[V2560,V2561,V2562]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2509) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2563) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2564) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2565) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2566) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2567,V2568) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2569) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2570,V2571,V2572]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2573,V2574,V2575]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2576) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2577) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2578) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2579) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2569) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2580) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2581,V2582,V2580) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2581,V2582,V2580) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2580) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2569) +| | | | | Redo: claim.time(claim12,V2567,V2568) +| | | | | Fail: claim.time(claim12,V2567,V2568) +| | | | | Redo: person.dob(person4,V2566) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2567,V2568) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2569) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2583,V2584,V2585]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2586,V2587,V2588]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2589) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2590) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2591) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2592) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2569) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2580) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2593,V2594,V2580) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2593,V2594,V2580) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2580) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2569) +| | | | | Redo: claim.time(claim12,V2567,V2568) +| | | | | Fail: claim.time(claim12,V2567,V2568) +| | | | | Redo: person.dob(person4,V2566) +| | | | | Fail: person.dob(person4,V2566) +| | | | | Redo: claim.claimant(claim12,V2565) +| | | | | Fail: claim.claimant(claim12,V2565) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2595) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2595) +| | | | Fail: covered_list_with_location(V2595) +| | | | Call: covered_list_with_service_provider(V2596) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2596) +| | | | Fail: covered_list_with_service_provider(V2596) +| | | | Call: covered_list(V2597) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2597) +| | | | Fail: covered_list(V2597) +| | | | Call: claim.location(claim12,V2598) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2599) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2600) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2600) +| Fail: claim.claimant(claim12,V2600) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2599) +| | | | Fail: claim.service_provider(claim12,V2599) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2598) +| | | | Fail: claim.location(claim12,V2598) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2564) +| | | Fail: claim.reason(claim12,V2564) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2563) +| | | Fail: claim.hospital(claim12,V2563) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2509) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2505) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2501) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2497) +| | | Redo: policy.enddate(policy1,person4,V2496) +| | | Fail: policy.enddate(policy1,person4,V2496) +| | | Redo: policy.startdate(policy1,person4,V2495) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2496) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2497) +| | | | Call: evaluate(parsedate(02_09_2023),[V2601,V2602,V2603]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2497) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2501) +| | | | Call: evaluate(parsedate(02_09_2023),[V2604,V2605,V2606]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2501) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2505) +| | | | Call: evaluate(parsedate(30_06_2024),[V2607,V2608,V2609]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2505) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2509) +| | | | Call: evaluate(parsedate(01_08_2023),[V2610,V2611,V2612]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2509) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2613) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2614) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2615) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2616) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2617,V2618) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2619) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2620,V2621,V2622]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2623,V2624,V2625]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2626) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2627) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2628) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2629) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2619) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2630) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2631,V2632,V2630) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2631,V2632,V2630) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2630) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2619) +| | | | | Redo: claim.time(claim12,V2617,V2618) +| | | | | Fail: claim.time(claim12,V2617,V2618) +| | | | | Redo: person.dob(person4,V2616) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2617,V2618) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2619) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2633,V2634,V2635]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2636,V2637,V2638]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2639) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2640) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2641) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2642) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2619) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2630) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2643,V2644,V2630) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2643,V2644,V2630) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2630) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2619) +| | | | | Redo: claim.time(claim12,V2617,V2618) +| | | | | Fail: claim.time(claim12,V2617,V2618) +| | | | | Redo: person.dob(person4,V2616) +| | | | | Fail: person.dob(person4,V2616) +| | | | | Redo: claim.claimant(claim12,V2615) +| | | | | Fail: claim.claimant(claim12,V2615) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2645) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2645) +| | | | Fail: covered_list_with_location(V2645) +| | | | Call: covered_list_with_service_provider(V2646) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2646) +| | | | Fail: covered_list_with_service_provider(V2646) +| | | | Call: covered_list(V2647) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2647) +| | | | Fail: covered_list(V2647) +| | | | Call: claim.location(claim12,V2648) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2649) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2650) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2650) +| Fail: claim.claimant(claim12,V2650) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2649) +| | | | Fail: claim.service_provider(claim12,V2649) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2648) +| | | | Fail: claim.location(claim12,V2648) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2614) +| | | Fail: claim.reason(claim12,V2614) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2613) +| | | Fail: claim.hospital(claim12,V2613) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2509) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2505) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2501) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2497) +| | | Redo: policy.enddate(policy1,person4,V2496) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2497) +| | | | Call: evaluate(parsedate(02_09_2023),[V2651,V2652,V2653]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2497) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2501) +| | | | Call: evaluate(parsedate(02_09_2023),[V2654,V2655,V2656]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2501) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2505) +| | | | Call: evaluate(parsedate(30_06_2024),[V2657,V2658,V2659]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2505) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2509) +| | | | Call: evaluate(parsedate(01_08_2023),[V2660,V2661,V2662]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2509) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim12,policy1) +| | | Call: claim.hospital(claim12,V2663) +| | | Exit: claim.hospital(claim12,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim12,V2664) +| | | Exit: claim.reason(claim12,outpatient_surgical_services) +| | | Call: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim12,V2665) +| | | | | Exit: claim.claimant(claim12,person4) +| | | | | Call: person.dob(person4,V2666) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2667,V2668) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2669) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2670,V2671,V2672]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2673,V2674,V2675]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2676) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2677) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2678) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2679) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2669) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2680) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2681,V2682,V2680) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2681,V2682,V2680) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2680) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2669) +| | | | | Redo: claim.time(claim12,V2667,V2668) +| | | | | Fail: claim.time(claim12,V2667,V2668) +| | | | | Redo: person.dob(person4,V2666) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim12,V2667,V2668) +| | | | | Exit: claim.time(claim12,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2669) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2683,V2684,V2685]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2686,V2687,V2688]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2689) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2690) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2691) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2692) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2669) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2680) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2693,V2694,V2680) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2693,V2694,V2680) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2680) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2669) +| | | | | Redo: claim.time(claim12,V2667,V2668) +| | | | | Fail: claim.time(claim12,V2667,V2668) +| | | | | Redo: person.dob(person4,V2666) +| | | | | Fail: person.dob(person4,V2666) +| | | | | Redo: claim.claimant(claim12,V2665) +| | | | | Fail: claim.claimant(claim12,V2665) +| | | | Fail: check_policy_year_limit(claim12,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2695) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2695) +| | | | Fail: covered_list_with_location(V2695) +| | | | Call: covered_list_with_service_provider(V2696) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2696) +| | | | Fail: covered_list_with_service_provider(V2696) +| | | | Call: covered_list(V2697) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2697) +| | | | Fail: covered_list(V2697) +| | | | Call: claim.location(claim12,V2698) +| | | | Exit: claim.location(claim12,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim12,V2699) +| | | | Exit: claim.service_provider(claim12,anesthetist) +| | | | Call: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Exit: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | Exit: eligible_service(C,P,R) +| | | Call: ~exception(claim12,policy1) +Call: exception(claim12,policy1) +| Call: claim.claimant(claim12,V2700) +| Exit: claim.claimant(claim12,person4) +| Call: person.occupation(person4,armed_forces) +| Fail: person.occupation(person4,armed_forces) +| Redo: claim.claimant(claim12,V2700) +| Fail: claim.claimant(claim12,V2700) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +| Call: claim.reason(claim12,home_health_care) +| Fail: claim.reason(claim12,home_health_care) +Fail: exception(claim12,policy1) +| | | Exit: ~exception(claim12,policy1) +| | Exit: valid_hospitalization(C,P) +| Exit: covered_under_policy(C,P,T) +Exit: covered(claim12) +Redo: covered(X) +| Redo: covered_under_policy(C,P,T) +| | Redo: valid_hospitalization(C,P) +| | | Redo: eligible_service(C,P,R) +| | | | Redo: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Fail: valid_service_provider(outpatient_surgical_services,anesthetist) +| | | | Redo: claim.service_provider(claim12,V2699) +| | | | Fail: claim.service_provider(claim12,V2699) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim12,V2698) +| | | | Fail: claim.location(claim12,V2698) +| | | Fail: eligible_service(claim12,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim12,V2664) +| | | Fail: claim.reason(claim12,V2664) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim12,V2663) +| | | Fail: claim.hospital(claim12,V2663) +| | | Call: claim.reason(claim12,emergency_room) +| | | Fail: claim.reason(claim12,emergency_room) +| | Fail: valid_hospitalization(claim12,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2509) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2505) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2501) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2497) +| | | Redo: policy.enddate(policy1,person4,V2496) +| | | Fail: policy.enddate(policy1,person4,V2496) +| | | Redo: policy.startdate(policy1,person4,V2495) +| | | Fail: policy.startdate(policy1,person4,V2495) +| | | Redo: claim.hosp_end_time(claim12,V2493,V2494) +| | | Fail: claim.hosp_end_time(claim12,V2493,V2494) +| | | Redo: claim.hosp_start_time(claim12,V2491,V2492) +| | | Fail: claim.hosp_start_time(claim12,V2491,V2492) +| | | Redo: claim.claimant(claim12,V2490) +| | | Fail: claim.claimant(claim12,V2490) +| | Fail: policy_active(claim12,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Fail: policy.insuree(policy1,person4) +| | | Redo: claim.claimant(claim12,V2278) +| | | Fail: claim.claimant(claim12,V2278) +| | Fail: valid_insuree(claim12,policy1) +| Fail: covered_under_policy(claim12,policy1,cardinal) +| Redo: policy.type(policy1,V1854) +| Fail: policy.type(policy1,V1854) +| Redo: claim.policy(X,V1853) +| Exit: claim.policy(claim13,policy1) +| Call: policy.type(policy1,V1854) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim13,policy1,cardinal) +| | Call: valid_insuree(claim13,policy1) +| | | Call: claim.claimant(claim13,V2701) +| | | Exit: claim.claimant(claim13,person4) +| | | Call: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim13,policy1) +| | | Call: claim.claimant(claim13,V2702) +| | | Exit: claim.claimant(claim13,person4) +| | | Call: claim.hosp_start_time(claim13,V2703,V2704) +| | | Exit: claim.hosp_start_time(claim13,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim13,V2705,V2706) +| | | Exit: claim.hosp_end_time(claim13,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V2707) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2708) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2709) +| | | | Call: evaluate(parsedate(02_09_2023),[V2710,V2711,V2712]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2709) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2713) +| | | | Call: evaluate(parsedate(02_09_2023),[V2714,V2715,V2716]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2713) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2717) +| | | | Call: evaluate(parsedate(30_06_2024),[V2718,V2719,V2720]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2717) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2721) +| | | | Call: evaluate(parsedate(01_08_2023),[V2722,V2723,V2724]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2721) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V2725) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V2726) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V2727) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V2728) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2729,V2730) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2731) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2732,V2733,V2734]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2735,V2736,V2737]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2738) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2739) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2740) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2741) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2731) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2742) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2743,V2744,V2742) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2743,V2744,V2742) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2742) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2731) +| | | | | Redo: claim.time(claim13,V2729,V2730) +| | | | | Fail: claim.time(claim13,V2729,V2730) +| | | | | Redo: person.dob(person4,V2728) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2729,V2730) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2731) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2745,V2746,V2747]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2748,V2749,V2750]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2751) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2752) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2753) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2754) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2731) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2742) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2755,V2756,V2742) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2755,V2756,V2742) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2742) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2731) +| | | | | Redo: claim.time(claim13,V2729,V2730) +| | | | | Fail: claim.time(claim13,V2729,V2730) +| | | | | Redo: person.dob(person4,V2728) +| | | | | Fail: person.dob(person4,V2728) +| | | | | Redo: claim.claimant(claim13,V2727) +| | | | | Fail: claim.claimant(claim13,V2727) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2757) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2757) +| | | | Fail: covered_list_with_location(V2757) +| | | | Call: covered_list_with_service_provider(V2758) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2758) +| | | | Fail: covered_list_with_service_provider(V2758) +| | | | Call: covered_list(V2759) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2759) +| | | | Fail: covered_list(V2759) +| | | | Call: claim.location(claim13,V2760) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V2761) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V2761) +| | | | Fail: claim.service_provider(claim13,V2761) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V2760) +| | | | Fail: claim.location(claim13,V2760) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V2726) +| | | Fail: claim.reason(claim13,V2726) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V2725) +| | | Fail: claim.hospital(claim13,V2725) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2721) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2717) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2713) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2709) +| | | Redo: policy.enddate(policy1,person4,V2708) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2709) +| | | | Call: evaluate(parsedate(02_09_2023),[V2762,V2763,V2764]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2709) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2713) +| | | | Call: evaluate(parsedate(02_09_2023),[V2765,V2766,V2767]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2713) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2717) +| | | | Call: evaluate(parsedate(30_06_2024),[V2768,V2769,V2770]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2717) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2721) +| | | | Call: evaluate(parsedate(01_08_2023),[V2771,V2772,V2773]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2721) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V2774) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V2775) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V2776) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V2777) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2778,V2779) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2780) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2781,V2782,V2783]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2784,V2785,V2786]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2787) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2788) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2789) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2790) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2780) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2791) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2792,V2793,V2791) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2792,V2793,V2791) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2791) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2780) +| | | | | Redo: claim.time(claim13,V2778,V2779) +| | | | | Fail: claim.time(claim13,V2778,V2779) +| | | | | Redo: person.dob(person4,V2777) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2778,V2779) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2780) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2794,V2795,V2796]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2797,V2798,V2799]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2800) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2801) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2802) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2803) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2780) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2791) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2804,V2805,V2791) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2804,V2805,V2791) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2791) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2780) +| | | | | Redo: claim.time(claim13,V2778,V2779) +| | | | | Fail: claim.time(claim13,V2778,V2779) +| | | | | Redo: person.dob(person4,V2777) +| | | | | Fail: person.dob(person4,V2777) +| | | | | Redo: claim.claimant(claim13,V2776) +| | | | | Fail: claim.claimant(claim13,V2776) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2806) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2806) +| | | | Fail: covered_list_with_location(V2806) +| | | | Call: covered_list_with_service_provider(V2807) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2807) +| | | | Fail: covered_list_with_service_provider(V2807) +| | | | Call: covered_list(V2808) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2808) +| | | | Fail: covered_list(V2808) +| | | | Call: claim.location(claim13,V2809) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V2810) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V2810) +| | | | Fail: claim.service_provider(claim13,V2810) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V2809) +| | | | Fail: claim.location(claim13,V2809) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V2775) +| | | Fail: claim.reason(claim13,V2775) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V2774) +| | | Fail: claim.hospital(claim13,V2774) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2721) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2717) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2713) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2709) +| | | Redo: policy.enddate(policy1,person4,V2708) +| | | Fail: policy.enddate(policy1,person4,V2708) +| | | Redo: policy.startdate(policy1,person4,V2707) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2708) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2709) +| | | | Call: evaluate(parsedate(02_09_2023),[V2811,V2812,V2813]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2709) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2713) +| | | | Call: evaluate(parsedate(02_09_2023),[V2814,V2815,V2816]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2713) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2717) +| | | | Call: evaluate(parsedate(30_06_2024),[V2817,V2818,V2819]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2717) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2721) +| | | | Call: evaluate(parsedate(01_08_2023),[V2820,V2821,V2822]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2721) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V2823) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V2824) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V2825) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V2826) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2827,V2828) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2829) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2830,V2831,V2832]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2833,V2834,V2835]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2836) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2837) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2838) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2839) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2829) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2840) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2841,V2842,V2840) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2841,V2842,V2840) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2840) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2829) +| | | | | Redo: claim.time(claim13,V2827,V2828) +| | | | | Fail: claim.time(claim13,V2827,V2828) +| | | | | Redo: person.dob(person4,V2826) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2827,V2828) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2829) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2843,V2844,V2845]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2846,V2847,V2848]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2849) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2850) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2851) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2852) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2829) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2840) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2853,V2854,V2840) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2853,V2854,V2840) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2840) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2829) +| | | | | Redo: claim.time(claim13,V2827,V2828) +| | | | | Fail: claim.time(claim13,V2827,V2828) +| | | | | Redo: person.dob(person4,V2826) +| | | | | Fail: person.dob(person4,V2826) +| | | | | Redo: claim.claimant(claim13,V2825) +| | | | | Fail: claim.claimant(claim13,V2825) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2855) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2855) +| | | | Fail: covered_list_with_location(V2855) +| | | | Call: covered_list_with_service_provider(V2856) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2856) +| | | | Fail: covered_list_with_service_provider(V2856) +| | | | Call: covered_list(V2857) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2857) +| | | | Fail: covered_list(V2857) +| | | | Call: claim.location(claim13,V2858) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V2859) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V2859) +| | | | Fail: claim.service_provider(claim13,V2859) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V2858) +| | | | Fail: claim.location(claim13,V2858) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V2824) +| | | Fail: claim.reason(claim13,V2824) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V2823) +| | | Fail: claim.hospital(claim13,V2823) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2721) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2717) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2713) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2709) +| | | Redo: policy.enddate(policy1,person4,V2708) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2709) +| | | | Call: evaluate(parsedate(02_09_2023),[V2860,V2861,V2862]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2709) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2713) +| | | | Call: evaluate(parsedate(02_09_2023),[V2863,V2864,V2865]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2713) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2717) +| | | | Call: evaluate(parsedate(30_06_2024),[V2866,V2867,V2868]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2717) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2721) +| | | | Call: evaluate(parsedate(01_08_2023),[V2869,V2870,V2871]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2721) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V2872) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V2873) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V2874) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V2875) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2876,V2877) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2878) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2879,V2880,V2881]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2882,V2883,V2884]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2885) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2886) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2887) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2888) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2878) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2889) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2890,V2891,V2889) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2890,V2891,V2889) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2889) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2878) +| | | | | Redo: claim.time(claim13,V2876,V2877) +| | | | | Fail: claim.time(claim13,V2876,V2877) +| | | | | Redo: person.dob(person4,V2875) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2876,V2877) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2878) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2892,V2893,V2894]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2895,V2896,V2897]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2898) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2899) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2900) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2901) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2878) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2889) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2902,V2903,V2889) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2902,V2903,V2889) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2889) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2878) +| | | | | Redo: claim.time(claim13,V2876,V2877) +| | | | | Fail: claim.time(claim13,V2876,V2877) +| | | | | Redo: person.dob(person4,V2875) +| | | | | Fail: person.dob(person4,V2875) +| | | | | Redo: claim.claimant(claim13,V2874) +| | | | | Fail: claim.claimant(claim13,V2874) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2904) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2904) +| | | | Fail: covered_list_with_location(V2904) +| | | | Call: covered_list_with_service_provider(V2905) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2905) +| | | | Fail: covered_list_with_service_provider(V2905) +| | | | Call: covered_list(V2906) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2906) +| | | | Fail: covered_list(V2906) +| | | | Call: claim.location(claim13,V2907) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V2908) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V2908) +| | | | Fail: claim.service_provider(claim13,V2908) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V2907) +| | | | Fail: claim.location(claim13,V2907) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V2873) +| | | Fail: claim.reason(claim13,V2873) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V2872) +| | | Fail: claim.hospital(claim13,V2872) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2721) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2717) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2713) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2709) +| | | Redo: policy.enddate(policy1,person4,V2708) +| | | Fail: policy.enddate(policy1,person4,V2708) +| | | Redo: policy.startdate(policy1,person4,V2707) +| | | Fail: policy.startdate(policy1,person4,V2707) +| | | Redo: claim.hosp_end_time(claim13,V2705,V2706) +| | | Fail: claim.hosp_end_time(claim13,V2705,V2706) +| | | Redo: claim.hosp_start_time(claim13,V2703,V2704) +| | | Fail: claim.hosp_start_time(claim13,V2703,V2704) +| | | Redo: claim.claimant(claim13,V2702) +| | | Fail: claim.claimant(claim13,V2702) +| | Fail: policy_active(claim13,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim13,policy1) +| | | Call: claim.claimant(claim13,V2909) +| | | Exit: claim.claimant(claim13,person4) +| | | Call: claim.hosp_start_time(claim13,V2910,V2911) +| | | Exit: claim.hosp_start_time(claim13,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim13,V2912,V2913) +| | | Exit: claim.hosp_end_time(claim13,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V2914) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2915) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2916) +| | | | Call: evaluate(parsedate(02_09_2023),[V2917,V2918,V2919]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2916) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2920) +| | | | Call: evaluate(parsedate(02_09_2023),[V2921,V2922,V2923]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2920) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2924) +| | | | Call: evaluate(parsedate(30_06_2024),[V2925,V2926,V2927]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2924) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2928) +| | | | Call: evaluate(parsedate(01_08_2023),[V2929,V2930,V2931]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2928) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V2932) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V2933) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V2934) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V2935) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2936,V2937) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2938) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2939,V2940,V2941]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2942,V2943,V2944]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2945) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2946) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2947) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2948) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2938) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2949) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2950,V2951,V2949) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2950,V2951,V2949) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2949) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2938) +| | | | | Redo: claim.time(claim13,V2936,V2937) +| | | | | Fail: claim.time(claim13,V2936,V2937) +| | | | | Redo: person.dob(person4,V2935) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2936,V2937) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2938) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2952,V2953,V2954]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2955,V2956,V2957]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2958) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2959) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2960) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2961) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2938) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2949) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2962,V2963,V2949) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2962,V2963,V2949) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2949) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2938) +| | | | | Redo: claim.time(claim13,V2936,V2937) +| | | | | Fail: claim.time(claim13,V2936,V2937) +| | | | | Redo: person.dob(person4,V2935) +| | | | | Fail: person.dob(person4,V2935) +| | | | | Redo: claim.claimant(claim13,V2934) +| | | | | Fail: claim.claimant(claim13,V2934) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V2964) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V2964) +| | | | Fail: covered_list_with_location(V2964) +| | | | Call: covered_list_with_service_provider(V2965) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V2965) +| | | | Fail: covered_list_with_service_provider(V2965) +| | | | Call: covered_list(V2966) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V2966) +| | | | Fail: covered_list(V2966) +| | | | Call: claim.location(claim13,V2967) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V2968) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V2968) +| | | | Fail: claim.service_provider(claim13,V2968) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V2967) +| | | | Fail: claim.location(claim13,V2967) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V2933) +| | | Fail: claim.reason(claim13,V2933) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V2932) +| | | Fail: claim.hospital(claim13,V2932) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2928) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2924) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2920) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2916) +| | | Redo: policy.enddate(policy1,person4,V2915) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2916) +| | | | Call: evaluate(parsedate(02_09_2023),[V2969,V2970,V2971]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2916) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2920) +| | | | Call: evaluate(parsedate(02_09_2023),[V2972,V2973,V2974]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2920) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2924) +| | | | Call: evaluate(parsedate(30_06_2024),[V2975,V2976,V2977]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2924) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2928) +| | | | Call: evaluate(parsedate(01_08_2023),[V2978,V2979,V2980]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2928) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V2981) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V2982) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V2983) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V2984) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2985,V2986) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2987) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V2988,V2989,V2990]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V2991,V2992,V2993]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V2994) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V2995) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V2996) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V2997) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2987) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2998) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V2999,V3000,V2998) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V2999,V3000,V2998) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2998) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2987) +| | | | | Redo: claim.time(claim13,V2985,V2986) +| | | | | Fail: claim.time(claim13,V2985,V2986) +| | | | | Redo: person.dob(person4,V2984) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V2985,V2986) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V2987) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3001,V3002,V3003]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3004,V3005,V3006]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3007) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3008) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3009) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3010) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V2987) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V2998) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3011,V3012,V2998) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3011,V3012,V2998) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V2998) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V2987) +| | | | | Redo: claim.time(claim13,V2985,V2986) +| | | | | Fail: claim.time(claim13,V2985,V2986) +| | | | | Redo: person.dob(person4,V2984) +| | | | | Fail: person.dob(person4,V2984) +| | | | | Redo: claim.claimant(claim13,V2983) +| | | | | Fail: claim.claimant(claim13,V2983) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3013) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3013) +| | | | Fail: covered_list_with_location(V3013) +| | | | Call: covered_list_with_service_provider(V3014) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3014) +| | | | Fail: covered_list_with_service_provider(V3014) +| | | | Call: covered_list(V3015) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3015) +| | | | Fail: covered_list(V3015) +| | | | Call: claim.location(claim13,V3016) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3017) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3017) +| | | | Fail: claim.service_provider(claim13,V3017) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3016) +| | | | Fail: claim.location(claim13,V3016) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V2982) +| | | Fail: claim.reason(claim13,V2982) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V2981) +| | | Fail: claim.hospital(claim13,V2981) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2928) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2924) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2920) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2916) +| | | Redo: policy.enddate(policy1,person4,V2915) +| | | Fail: policy.enddate(policy1,person4,V2915) +| | | Redo: policy.startdate(policy1,person4,V2914) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V2915) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2916) +| | | | Call: evaluate(parsedate(02_09_2023),[V3018,V3019,V3020]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2916) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2920) +| | | | Call: evaluate(parsedate(02_09_2023),[V3021,V3022,V3023]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2920) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2924) +| | | | Call: evaluate(parsedate(30_06_2024),[V3024,V3025,V3026]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2924) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2928) +| | | | Call: evaluate(parsedate(01_08_2023),[V3027,V3028,V3029]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2928) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3030) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3031) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3032) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3033) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3034,V3035) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3036) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3037,V3038,V3039]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3040,V3041,V3042]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3043) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3044) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3045) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3046) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3036) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3047) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3048,V3049,V3047) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3048,V3049,V3047) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3047) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3036) +| | | | | Redo: claim.time(claim13,V3034,V3035) +| | | | | Fail: claim.time(claim13,V3034,V3035) +| | | | | Redo: person.dob(person4,V3033) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3034,V3035) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3036) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3050,V3051,V3052]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3053,V3054,V3055]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3056) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3057) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3058) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3059) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3036) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3047) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3060,V3061,V3047) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3060,V3061,V3047) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3047) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3036) +| | | | | Redo: claim.time(claim13,V3034,V3035) +| | | | | Fail: claim.time(claim13,V3034,V3035) +| | | | | Redo: person.dob(person4,V3033) +| | | | | Fail: person.dob(person4,V3033) +| | | | | Redo: claim.claimant(claim13,V3032) +| | | | | Fail: claim.claimant(claim13,V3032) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3062) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3062) +| | | | Fail: covered_list_with_location(V3062) +| | | | Call: covered_list_with_service_provider(V3063) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3063) +| | | | Fail: covered_list_with_service_provider(V3063) +| | | | Call: covered_list(V3064) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3064) +| | | | Fail: covered_list(V3064) +| | | | Call: claim.location(claim13,V3065) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3066) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3066) +| | | | Fail: claim.service_provider(claim13,V3066) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3065) +| | | | Fail: claim.location(claim13,V3065) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3031) +| | | Fail: claim.reason(claim13,V3031) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3030) +| | | Fail: claim.hospital(claim13,V3030) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2928) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2924) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2920) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2916) +| | | Redo: policy.enddate(policy1,person4,V2915) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V2916) +| | | | Call: evaluate(parsedate(02_09_2023),[V3067,V3068,V3069]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2916) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V2920) +| | | | Call: evaluate(parsedate(02_09_2023),[V3070,V3071,V3072]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V2920) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V2924) +| | | | Call: evaluate(parsedate(30_06_2024),[V3073,V3074,V3075]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V2924) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V2928) +| | | | Call: evaluate(parsedate(01_08_2023),[V3076,V3077,V3078]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V2928) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3079) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3080) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3081) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3082) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3083,V3084) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3085) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3086,V3087,V3088]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3089,V3090,V3091]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3092) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3093) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3094) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3095) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3085) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3096) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3097,V3098,V3096) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3097,V3098,V3096) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3096) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3085) +| | | | | Redo: claim.time(claim13,V3083,V3084) +| | | | | Fail: claim.time(claim13,V3083,V3084) +| | | | | Redo: person.dob(person4,V3082) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3083,V3084) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3085) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3099,V3100,V3101]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3102,V3103,V3104]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3105) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3106) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3107) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3108) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3085) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3096) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3109,V3110,V3096) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3109,V3110,V3096) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3096) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3085) +| | | | | Redo: claim.time(claim13,V3083,V3084) +| | | | | Fail: claim.time(claim13,V3083,V3084) +| | | | | Redo: person.dob(person4,V3082) +| | | | | Fail: person.dob(person4,V3082) +| | | | | Redo: claim.claimant(claim13,V3081) +| | | | | Fail: claim.claimant(claim13,V3081) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3111) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3111) +| | | | Fail: covered_list_with_location(V3111) +| | | | Call: covered_list_with_service_provider(V3112) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3112) +| | | | Fail: covered_list_with_service_provider(V3112) +| | | | Call: covered_list(V3113) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3113) +| | | | Fail: covered_list(V3113) +| | | | Call: claim.location(claim13,V3114) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3115) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3115) +| | | | Fail: claim.service_provider(claim13,V3115) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3114) +| | | | Fail: claim.location(claim13,V3114) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3080) +| | | Fail: claim.reason(claim13,V3080) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3079) +| | | Fail: claim.hospital(claim13,V3079) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V2928) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V2924) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2920) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V2916) +| | | Redo: policy.enddate(policy1,person4,V2915) +| | | Fail: policy.enddate(policy1,person4,V2915) +| | | Redo: policy.startdate(policy1,person4,V2914) +| | | Fail: policy.startdate(policy1,person4,V2914) +| | | Redo: claim.hosp_end_time(claim13,V2912,V2913) +| | | Fail: claim.hosp_end_time(claim13,V2912,V2913) +| | | Redo: claim.hosp_start_time(claim13,V2910,V2911) +| | | Fail: claim.hosp_start_time(claim13,V2910,V2911) +| | | Redo: claim.claimant(claim13,V2909) +| | | Fail: claim.claimant(claim13,V2909) +| | Fail: policy_active(claim13,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Fail: policy.insuree(policy1,person4) +| | | Redo: claim.claimant(claim13,V2701) +| | | Fail: claim.claimant(claim13,V2701) +| | Fail: valid_insuree(claim13,policy1) +| Fail: covered_under_policy(claim13,policy1,cardinal) +| Redo: policy.type(policy1,V1854) +| Exit: policy.type(policy1,cardinal) +| Call: covered_under_policy(claim13,policy1,cardinal) +| | Call: valid_insuree(claim13,policy1) +| | | Call: claim.claimant(claim13,V3116) +| | | Exit: claim.claimant(claim13,person4) +| | | Call: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim13,policy1) +| | | Call: claim.claimant(claim13,V3117) +| | | Exit: claim.claimant(claim13,person4) +| | | Call: claim.hosp_start_time(claim13,V3118,V3119) +| | | Exit: claim.hosp_start_time(claim13,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim13,V3120,V3121) +| | | Exit: claim.hosp_end_time(claim13,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V3122) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V3123) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3124) +| | | | Call: evaluate(parsedate(02_09_2023),[V3125,V3126,V3127]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3124) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3128) +| | | | Call: evaluate(parsedate(02_09_2023),[V3129,V3130,V3131]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3128) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3132) +| | | | Call: evaluate(parsedate(30_06_2024),[V3133,V3134,V3135]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3132) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3136) +| | | | Call: evaluate(parsedate(01_08_2023),[V3137,V3138,V3139]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3136) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3140) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3141) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3142) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3143) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3144,V3145) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3146) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3147,V3148,V3149]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3150,V3151,V3152]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3153) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3154) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3155) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3156) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3146) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3157) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3158,V3159,V3157) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3158,V3159,V3157) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3157) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3146) +| | | | | Redo: claim.time(claim13,V3144,V3145) +| | | | | Fail: claim.time(claim13,V3144,V3145) +| | | | | Redo: person.dob(person4,V3143) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3144,V3145) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3146) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3160,V3161,V3162]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3163,V3164,V3165]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3166) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3167) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3168) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3169) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3146) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3157) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3170,V3171,V3157) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3170,V3171,V3157) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3157) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3146) +| | | | | Redo: claim.time(claim13,V3144,V3145) +| | | | | Fail: claim.time(claim13,V3144,V3145) +| | | | | Redo: person.dob(person4,V3143) +| | | | | Fail: person.dob(person4,V3143) +| | | | | Redo: claim.claimant(claim13,V3142) +| | | | | Fail: claim.claimant(claim13,V3142) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3172) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3172) +| | | | Fail: covered_list_with_location(V3172) +| | | | Call: covered_list_with_service_provider(V3173) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3173) +| | | | Fail: covered_list_with_service_provider(V3173) +| | | | Call: covered_list(V3174) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3174) +| | | | Fail: covered_list(V3174) +| | | | Call: claim.location(claim13,V3175) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3176) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3176) +| | | | Fail: claim.service_provider(claim13,V3176) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3175) +| | | | Fail: claim.location(claim13,V3175) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3141) +| | | Fail: claim.reason(claim13,V3141) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3140) +| | | Fail: claim.hospital(claim13,V3140) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3136) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3132) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3128) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3124) +| | | Redo: policy.enddate(policy1,person4,V3123) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3124) +| | | | Call: evaluate(parsedate(02_09_2023),[V3177,V3178,V3179]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3124) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3128) +| | | | Call: evaluate(parsedate(02_09_2023),[V3180,V3181,V3182]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3128) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3132) +| | | | Call: evaluate(parsedate(30_06_2024),[V3183,V3184,V3185]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3132) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3136) +| | | | Call: evaluate(parsedate(01_08_2023),[V3186,V3187,V3188]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3136) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3189) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3190) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3191) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3192) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3193,V3194) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3195) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3196,V3197,V3198]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3199,V3200,V3201]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3202) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3203) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3204) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3205) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3195) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3206) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3207,V3208,V3206) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3207,V3208,V3206) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3206) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3195) +| | | | | Redo: claim.time(claim13,V3193,V3194) +| | | | | Fail: claim.time(claim13,V3193,V3194) +| | | | | Redo: person.dob(person4,V3192) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3193,V3194) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3195) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3209,V3210,V3211]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3212,V3213,V3214]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3215) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3216) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3217) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3218) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3195) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3206) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3219,V3220,V3206) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3219,V3220,V3206) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3206) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3195) +| | | | | Redo: claim.time(claim13,V3193,V3194) +| | | | | Fail: claim.time(claim13,V3193,V3194) +| | | | | Redo: person.dob(person4,V3192) +| | | | | Fail: person.dob(person4,V3192) +| | | | | Redo: claim.claimant(claim13,V3191) +| | | | | Fail: claim.claimant(claim13,V3191) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3221) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3221) +| | | | Fail: covered_list_with_location(V3221) +| | | | Call: covered_list_with_service_provider(V3222) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3222) +| | | | Fail: covered_list_with_service_provider(V3222) +| | | | Call: covered_list(V3223) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3223) +| | | | Fail: covered_list(V3223) +| | | | Call: claim.location(claim13,V3224) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3225) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3225) +| | | | Fail: claim.service_provider(claim13,V3225) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3224) +| | | | Fail: claim.location(claim13,V3224) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3190) +| | | Fail: claim.reason(claim13,V3190) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3189) +| | | Fail: claim.hospital(claim13,V3189) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3136) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3132) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3128) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3124) +| | | Redo: policy.enddate(policy1,person4,V3123) +| | | Fail: policy.enddate(policy1,person4,V3123) +| | | Redo: policy.startdate(policy1,person4,V3122) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V3123) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3124) +| | | | Call: evaluate(parsedate(02_09_2023),[V3226,V3227,V3228]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3124) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3128) +| | | | Call: evaluate(parsedate(02_09_2023),[V3229,V3230,V3231]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3128) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3132) +| | | | Call: evaluate(parsedate(30_06_2024),[V3232,V3233,V3234]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3132) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3136) +| | | | Call: evaluate(parsedate(01_08_2023),[V3235,V3236,V3237]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3136) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3238) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3239) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3240) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3241) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3242,V3243) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3244) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3245,V3246,V3247]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3248,V3249,V3250]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3251) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3252) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3253) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3254) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3244) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3255) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3256,V3257,V3255) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3256,V3257,V3255) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3255) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3244) +| | | | | Redo: claim.time(claim13,V3242,V3243) +| | | | | Fail: claim.time(claim13,V3242,V3243) +| | | | | Redo: person.dob(person4,V3241) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3242,V3243) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3244) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3258,V3259,V3260]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3261,V3262,V3263]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3264) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3265) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3266) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3267) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3244) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3255) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3268,V3269,V3255) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3268,V3269,V3255) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3255) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3244) +| | | | | Redo: claim.time(claim13,V3242,V3243) +| | | | | Fail: claim.time(claim13,V3242,V3243) +| | | | | Redo: person.dob(person4,V3241) +| | | | | Fail: person.dob(person4,V3241) +| | | | | Redo: claim.claimant(claim13,V3240) +| | | | | Fail: claim.claimant(claim13,V3240) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3270) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3270) +| | | | Fail: covered_list_with_location(V3270) +| | | | Call: covered_list_with_service_provider(V3271) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3271) +| | | | Fail: covered_list_with_service_provider(V3271) +| | | | Call: covered_list(V3272) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3272) +| | | | Fail: covered_list(V3272) +| | | | Call: claim.location(claim13,V3273) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3274) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3274) +| | | | Fail: claim.service_provider(claim13,V3274) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3273) +| | | | Fail: claim.location(claim13,V3273) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3239) +| | | Fail: claim.reason(claim13,V3239) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3238) +| | | Fail: claim.hospital(claim13,V3238) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3136) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3132) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3128) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3124) +| | | Redo: policy.enddate(policy1,person4,V3123) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3124) +| | | | Call: evaluate(parsedate(02_09_2023),[V3275,V3276,V3277]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3124) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3128) +| | | | Call: evaluate(parsedate(02_09_2023),[V3278,V3279,V3280]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3128) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3132) +| | | | Call: evaluate(parsedate(30_06_2024),[V3281,V3282,V3283]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3132) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3136) +| | | | Call: evaluate(parsedate(01_08_2023),[V3284,V3285,V3286]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3136) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3287) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3288) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3289) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3290) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3291,V3292) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3293) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3294,V3295,V3296]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3297,V3298,V3299]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3300) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3301) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3302) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3303) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3293) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3304) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3305,V3306,V3304) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3305,V3306,V3304) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3304) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3293) +| | | | | Redo: claim.time(claim13,V3291,V3292) +| | | | | Fail: claim.time(claim13,V3291,V3292) +| | | | | Redo: person.dob(person4,V3290) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3291,V3292) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3293) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3307,V3308,V3309]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3310,V3311,V3312]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3313) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3314) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3315) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3316) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3293) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3304) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3317,V3318,V3304) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3317,V3318,V3304) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3304) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3293) +| | | | | Redo: claim.time(claim13,V3291,V3292) +| | | | | Fail: claim.time(claim13,V3291,V3292) +| | | | | Redo: person.dob(person4,V3290) +| | | | | Fail: person.dob(person4,V3290) +| | | | | Redo: claim.claimant(claim13,V3289) +| | | | | Fail: claim.claimant(claim13,V3289) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3319) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3319) +| | | | Fail: covered_list_with_location(V3319) +| | | | Call: covered_list_with_service_provider(V3320) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3320) +| | | | Fail: covered_list_with_service_provider(V3320) +| | | | Call: covered_list(V3321) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3321) +| | | | Fail: covered_list(V3321) +| | | | Call: claim.location(claim13,V3322) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3323) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3323) +| | | | Fail: claim.service_provider(claim13,V3323) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3322) +| | | | Fail: claim.location(claim13,V3322) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3288) +| | | Fail: claim.reason(claim13,V3288) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3287) +| | | Fail: claim.hospital(claim13,V3287) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3136) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3132) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3128) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3124) +| | | Redo: policy.enddate(policy1,person4,V3123) +| | | Fail: policy.enddate(policy1,person4,V3123) +| | | Redo: policy.startdate(policy1,person4,V3122) +| | | Fail: policy.startdate(policy1,person4,V3122) +| | | Redo: claim.hosp_end_time(claim13,V3120,V3121) +| | | Fail: claim.hosp_end_time(claim13,V3120,V3121) +| | | Redo: claim.hosp_start_time(claim13,V3118,V3119) +| | | Fail: claim.hosp_start_time(claim13,V3118,V3119) +| | | Redo: claim.claimant(claim13,V3117) +| | | Fail: claim.claimant(claim13,V3117) +| | Fail: policy_active(claim13,policy1) +| | Redo: valid_insuree(C,P) +| | | Redo: policy.insuree(policy1,person4) +| | | Exit: policy.insuree(policy1,person4) +| | Exit: valid_insuree(C,P) +| | Call: policy_active(claim13,policy1) +| | | Call: claim.claimant(claim13,V3324) +| | | Exit: claim.claimant(claim13,person4) +| | | Call: claim.hosp_start_time(claim13,V3325,V3326) +| | | Exit: claim.hosp_start_time(claim13,02_09_2023,00_00) +| | | Call: claim.hosp_end_time(claim13,V3327,V3328) +| | | Exit: claim.hosp_end_time(claim13,02_09_2023,01_13) +| | | Call: policy.startdate(policy1,person4,V3329) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V3330) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3331) +| | | | Call: evaluate(parsedate(02_09_2023),[V3332,V3333,V3334]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3331) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3335) +| | | | Call: evaluate(parsedate(02_09_2023),[V3336,V3337,V3338]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3335) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3339) +| | | | Call: evaluate(parsedate(30_06_2024),[V3340,V3341,V3342]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3339) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3343) +| | | | Call: evaluate(parsedate(01_08_2023),[V3344,V3345,V3346]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3343) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3347) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3348) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3349) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3350) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3351,V3352) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3353) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3354,V3355,V3356]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3357,V3358,V3359]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3360) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3361) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3362) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3363) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3353) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3364) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3365,V3366,V3364) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3365,V3366,V3364) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3364) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3353) +| | | | | Redo: claim.time(claim13,V3351,V3352) +| | | | | Fail: claim.time(claim13,V3351,V3352) +| | | | | Redo: person.dob(person4,V3350) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3351,V3352) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3353) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3367,V3368,V3369]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3370,V3371,V3372]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3373) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3374) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3375) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3376) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3353) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3364) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3377,V3378,V3364) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3377,V3378,V3364) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3364) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3353) +| | | | | Redo: claim.time(claim13,V3351,V3352) +| | | | | Fail: claim.time(claim13,V3351,V3352) +| | | | | Redo: person.dob(person4,V3350) +| | | | | Fail: person.dob(person4,V3350) +| | | | | Redo: claim.claimant(claim13,V3349) +| | | | | Fail: claim.claimant(claim13,V3349) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3379) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3379) +| | | | Fail: covered_list_with_location(V3379) +| | | | Call: covered_list_with_service_provider(V3380) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3380) +| | | | Fail: covered_list_with_service_provider(V3380) +| | | | Call: covered_list(V3381) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3381) +| | | | Fail: covered_list(V3381) +| | | | Call: claim.location(claim13,V3382) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3383) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3383) +| | | | Fail: claim.service_provider(claim13,V3383) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3382) +| | | | Fail: claim.location(claim13,V3382) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3348) +| | | Fail: claim.reason(claim13,V3348) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3347) +| | | Fail: claim.hospital(claim13,V3347) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3343) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3339) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3335) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3331) +| | | Redo: policy.enddate(policy1,person4,V3330) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3331) +| | | | Call: evaluate(parsedate(02_09_2023),[V3384,V3385,V3386]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3331) | | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) | | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) -| | | Call: get_timestamp_from_date(02_09_2023,V15) -| | | | Call: evaluate(parsedate(02_09_2023),[V16,V17,V18]) +| | | Call: get_timestamp_from_date(02_09_2023,V3335) +| | | | Call: evaluate(parsedate(02_09_2023),[V3387,V3388,V3389]) | | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) -| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V15) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3335) | | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) | | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) -| | | Call: get_timestamp_from_date(30_06_2024,V19) -| | | | Call: evaluate(parsedate(30_06_2024),[V20,V21,V22]) +| | | Call: get_timestamp_from_date(30_06_2024,V3339) +| | | | Call: evaluate(parsedate(30_06_2024),[V3390,V3391,V3392]) | | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) -| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V19) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3339) | | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) | | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) -| | | Call: get_timestamp_from_date(01_08_2023,V23) -| | | | Call: evaluate(parsedate(01_08_2023),[V24,V25,V26]) +| | | Call: get_timestamp_from_date(01_08_2023,V3343) +| | | | Call: evaluate(parsedate(01_08_2023),[V3393,V3394,V3395]) | | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) -| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V23) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3343) | | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) | | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) | | | Call: leq(1690873200000,1693638000000) @@ -52,188 +12157,516 @@ Call: covered(X) | | | Call: leq(1693638000000,1719730800000) | | | Exit: leq(1693638000000,1719730800000) | | Exit: policy_active(C,P) -| | Call: valid_hospitalization(claim5,policy1) -| | | Call: claim.hospital(claim5,V27) -| | | Exit: claim.hospital(claim5,stanford_medical_center) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3396) +| | | Exit: claim.hospital(claim13,stanford_medical_center) | | | Call: valid_hospital(stanford_medical_center) | | | Exit: valid_hospital(stanford_medical_center) -| | | Call: claim.reason(claim5,V28) -| | | Exit: claim.reason(claim5,inpatient_care) -| | | Call: eligible_service(claim5,policy1,inpatient_care) -| | | | Call: check_policy_year_limit(claim5,inpatient_care) -| | | | | Call: claim.claimant(claim5,V29) -| | | | | Exit: claim.claimant(claim5,person3) -| | | | | Call: person.dob(person3,V30) -| | | | | Exit: person.dob(person3,01_01_2001) -| | | | | Call: claim.time(claim5,V31,V32) -| | | | | Exit: claim.time(claim5,01_01_2024,00_00) -| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V33) -| | | | | | Call: evaluate(parsedate(01_01_2024),[V34,V35,V36]) +| | | Call: claim.reason(claim13,V3397) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3398) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3399) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3400,V3401) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3402) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3403,V3404,V3405]) | | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) -| | | | | | Call: evaluate(parsedate(01_01_2001),[V37,V38,V39]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3406,V3407,V3408]) | | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) -| | | | | | Call: evaluate(minus(2024,2001),V40) +| | | | | | Call: evaluate(minus(2024,2001),V3409) | | | | | | Exit: evaluate(minus(2024,2001),23) -| | | | | | Call: evaluate(minus(01,01),V41) +| | | | | | Call: evaluate(minus(01,01),V3410) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(minus(01,01),V42) +| | | | | | Call: evaluate(minus(01,01),V3411) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(plus(imul(31,0),0),V43) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3412) | | | | | | Exit: evaluate(plus(imul(31,0),0),0) -| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V33) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3402) | | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) | | | | | Exit: get_date_diff(C_D,DOB,Age) -| | | | | Call: yearly_visit_limit(inpatient_care,23,V44) -| | | | | | Call: yearly_visit_limit(inpatient_care,V45,V46,V44) -| | | | | | Fail: yearly_visit_limit(inpatient_care,V45,V46,V44) -| | | | | Fail: yearly_visit_limit(inpatient_care,23,V44) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3413) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3414,V3415,V3413) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3414,V3415,V3413) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3413) | | | | | Redo: get_date_diff(C_D,DOB,Age) -| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V33) -| | | | | Redo: claim.time(claim5,V31,V32) -| | | | | Fail: claim.time(claim5,V31,V32) -| | | | | Redo: person.dob(person3,V30) -| | | | | Fail: person.dob(person3,V30) -| | | | | Redo: claim.claimant(claim5,V29) -| | | | | Fail: claim.claimant(claim5,V29) -| | | | Fail: check_policy_year_limit(claim5,inpatient_care) -| | | | Call: covered_list_with_location(V47) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3402) +| | | | | Redo: claim.time(claim13,V3400,V3401) +| | | | | Fail: claim.time(claim13,V3400,V3401) +| | | | | Redo: person.dob(person4,V3399) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3400,V3401) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3402) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3416,V3417,V3418]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3419,V3420,V3421]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3422) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3423) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3424) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3425) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3402) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3413) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3426,V3427,V3413) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3426,V3427,V3413) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3413) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3402) +| | | | | Redo: claim.time(claim13,V3400,V3401) +| | | | | Fail: claim.time(claim13,V3400,V3401) +| | | | | Redo: person.dob(person4,V3399) +| | | | | Fail: person.dob(person4,V3399) +| | | | | Redo: claim.claimant(claim13,V3398) +| | | | | Fail: claim.claimant(claim13,V3398) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3428) | | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Call: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Exit: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Call: claim.location(claim5,V48) -| | | | Exit: claim.location(claim5,hospital) -| | | | Call: valid_location(inpatient_care,hospital) -| | | | Exit: valid_location(inpatient_care,hospital) -| | | Exit: eligible_service(C,P,R) -| | | Call: ~exception(claim5,policy1) -Call: exception(claim5,policy1) -| Call: claim.claimant(claim5,V49) -| Exit: claim.claimant(claim5,person3) -| Call: person.occupation(person3,armed_forces) -| Fail: person.occupation(person3,armed_forces) -| Redo: claim.claimant(claim5,V49) -| Fail: claim.claimant(claim5,V49) -| Call: claim.reason(claim5,home_health_care) -| Fail: claim.reason(claim5,home_health_care) -| Call: claim.reason(claim5,home_health_care) -| Fail: claim.reason(claim5,home_health_care) -Fail: exception(claim5,policy1) -| | | Exit: ~exception(claim5,policy1) -| | Exit: valid_hospitalization(C,P) -| Exit: covered_under_policy(C,P,T) -Exit: covered(claim5) -Redo: covered(X) -| Redo: covered_under_policy(C,P,T) -| | Redo: valid_hospitalization(C,P) -| | | Redo: eligible_service(C,P,R) -| | | | Redo: valid_location(inpatient_care,hospital) -| | | | Fail: valid_location(inpatient_care,hospital) -| | | | Redo: claim.location(claim5,V48) -| | | | Fail: claim.location(claim5,V48) -| | | | Redo: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Fail: member(inpatient_care,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Redo: covered_list_with_location(V47) -| | | | Fail: covered_list_with_location(V47) -| | | | Call: covered_list_with_service_provider(V50) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3428) +| | | | Fail: covered_list_with_location(V3428) +| | | | Call: covered_list_with_service_provider(V3429) | | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) -| | | | Call: member(inpatient_care,[abortion,voluntary_sterilization_reversal]) -| | | | Fail: member(inpatient_care,[abortion,voluntary_sterilization_reversal]) -| | | | Redo: covered_list_with_service_provider(V50) -| | | | Fail: covered_list_with_service_provider(V50) -| | | | Call: covered_list(V51) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3429) +| | | | Fail: covered_list_with_service_provider(V3429) +| | | | Call: covered_list(V3430) | | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) -| | | | Call: member(inpatient_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) -| | | | Fail: member(inpatient_care,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) -| | | | Redo: covered_list(V51) -| | | | Fail: covered_list(V51) -| | | Fail: eligible_service(claim5,policy1,inpatient_care) -| | | Redo: claim.reason(claim5,V28) -| | | Fail: claim.reason(claim5,V28) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3430) +| | | | Fail: covered_list(V3430) +| | | | Call: claim.location(claim13,V3431) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3432) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3432) +| | | | Fail: claim.service_provider(claim13,V3432) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3431) +| | | | Fail: claim.location(claim13,V3431) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3397) +| | | Fail: claim.reason(claim13,V3397) | | | Redo: valid_hospital(stanford_medical_center) | | | Fail: valid_hospital(stanford_medical_center) -| | | Redo: claim.hospital(claim5,V27) -| | | Fail: claim.hospital(claim5,V27) -| | | Call: claim.reason(claim5,emergency_room) -| | | Fail: claim.reason(claim5,emergency_room) -| | Fail: valid_hospitalization(claim5,policy1) +| | | Redo: claim.hospital(claim13,V3396) +| | | Fail: claim.hospital(claim13,V3396) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) | | Redo: policy_active(C,P) | | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) -| | | Fail: get_timestamp_from_date(01_08_2023,V23) +| | | Fail: get_timestamp_from_date(01_08_2023,V3343) | | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) -| | | Fail: get_timestamp_from_date(30_06_2024,V19) +| | | Fail: get_timestamp_from_date(30_06_2024,V3339) | | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) -| | | Fail: get_timestamp_from_date(02_09_2023,V15) +| | | Fail: get_timestamp_from_date(02_09_2023,V3335) | | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) -| | | Fail: get_timestamp_from_date(02_09_2023,V11) -| | | Redo: policy.enddate(policy1,person3,V10) -| | | Fail: policy.enddate(policy1,person3,V10) -| | | Redo: policy.startdate(policy1,person3,V9) -| | | Fail: policy.startdate(policy1,person3,V9) -| | | Redo: claim.hosp_end_time(claim5,V7,V8) -| | | Fail: claim.hosp_end_time(claim5,V7,V8) -| | | Redo: claim.hosp_start_time(claim5,V5,V6) -| | | Fail: claim.hosp_start_time(claim5,V5,V6) -| | | Redo: claim.claimant(claim5,V4) -| | | Fail: claim.claimant(claim5,V4) -| | Fail: policy_active(claim5,policy1) +| | | Fail: get_timestamp_from_date(02_09_2023,V3331) +| | | Redo: policy.enddate(policy1,person4,V3330) +| | | Fail: policy.enddate(policy1,person4,V3330) +| | | Redo: policy.startdate(policy1,person4,V3329) +| | | Exit: policy.startdate(policy1,person4,01_08_2023) +| | | Call: policy.enddate(policy1,person4,V3330) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3331) +| | | | Call: evaluate(parsedate(02_09_2023),[V3433,V3434,V3435]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3331) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3335) +| | | | Call: evaluate(parsedate(02_09_2023),[V3436,V3437,V3438]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3335) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3339) +| | | | Call: evaluate(parsedate(30_06_2024),[V3439,V3440,V3441]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3339) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3343) +| | | | Call: evaluate(parsedate(01_08_2023),[V3442,V3443,V3444]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3343) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3445) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3446) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3447) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3448) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3449,V3450) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3451) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3452,V3453,V3454]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3455,V3456,V3457]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3458) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3459) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3460) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3461) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3451) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3462) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3463,V3464,V3462) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3463,V3464,V3462) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3462) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3451) +| | | | | Redo: claim.time(claim13,V3449,V3450) +| | | | | Fail: claim.time(claim13,V3449,V3450) +| | | | | Redo: person.dob(person4,V3448) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3449,V3450) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3451) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3465,V3466,V3467]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3468,V3469,V3470]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3471) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3472) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3473) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3474) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3451) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3462) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3475,V3476,V3462) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3475,V3476,V3462) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3462) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3451) +| | | | | Redo: claim.time(claim13,V3449,V3450) +| | | | | Fail: claim.time(claim13,V3449,V3450) +| | | | | Redo: person.dob(person4,V3448) +| | | | | Fail: person.dob(person4,V3448) +| | | | | Redo: claim.claimant(claim13,V3447) +| | | | | Fail: claim.claimant(claim13,V3447) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3477) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3477) +| | | | Fail: covered_list_with_location(V3477) +| | | | Call: covered_list_with_service_provider(V3478) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3478) +| | | | Fail: covered_list_with_service_provider(V3478) +| | | | Call: covered_list(V3479) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3479) +| | | | Fail: covered_list(V3479) +| | | | Call: claim.location(claim13,V3480) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3481) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3481) +| | | | Fail: claim.service_provider(claim13,V3481) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3480) +| | | | Fail: claim.location(claim13,V3480) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3446) +| | | Fail: claim.reason(claim13,V3446) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3445) +| | | Fail: claim.hospital(claim13,V3445) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3343) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3339) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3335) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3331) +| | | Redo: policy.enddate(policy1,person4,V3330) +| | | Exit: policy.enddate(policy1,person4,30_06_2024) +| | | Call: get_timestamp_from_date(02_09_2023,V3331) +| | | | Call: evaluate(parsedate(02_09_2023),[V3482,V3483,V3484]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3331) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Call: get_timestamp_from_date(02_09_2023,V3335) +| | | | Call: evaluate(parsedate(02_09_2023),[V3485,V3486,V3487]) +| | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3335) +| | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) +| | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Call: get_timestamp_from_date(30_06_2024,V3339) +| | | | Call: evaluate(parsedate(30_06_2024),[V3488,V3489,V3490]) +| | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3339) +| | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) +| | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Call: get_timestamp_from_date(01_08_2023,V3343) +| | | | Call: evaluate(parsedate(01_08_2023),[V3491,V3492,V3493]) +| | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3343) +| | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) +| | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Call: leq(1690873200000,1693638000000) +| | | Exit: leq(1690873200000,1693638000000) +| | | Call: leq(1693638000000,1719730800000) +| | | Exit: leq(1693638000000,1719730800000) +| | Exit: policy_active(C,P) +| | Call: valid_hospitalization(claim13,policy1) +| | | Call: claim.hospital(claim13,V3494) +| | | Exit: claim.hospital(claim13,stanford_medical_center) +| | | Call: valid_hospital(stanford_medical_center) +| | | Exit: valid_hospital(stanford_medical_center) +| | | Call: claim.reason(claim13,V3495) +| | | Exit: claim.reason(claim13,outpatient_surgical_services) +| | | Call: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | | Call: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | | Call: claim.claimant(claim13,V3496) +| | | | | Exit: claim.claimant(claim13,person4) +| | | | | Call: person.dob(person4,V3497) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3498,V3499) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3500) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3501,V3502,V3503]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3504,V3505,V3506]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3507) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3508) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3509) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3510) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3500) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3511) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3512,V3513,V3511) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3512,V3513,V3511) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3511) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3500) +| | | | | Redo: claim.time(claim13,V3498,V3499) +| | | | | Fail: claim.time(claim13,V3498,V3499) +| | | | | Redo: person.dob(person4,V3497) +| | | | | Exit: person.dob(person4,01_01_2001) +| | | | | Call: claim.time(claim13,V3498,V3499) +| | | | | Exit: claim.time(claim13,01_01_2024,00_00) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3500) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3514,V3515,V3516]) +| | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3517,V3518,V3519]) +| | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) +| | | | | | Call: evaluate(minus(2024,2001),V3520) +| | | | | | Exit: evaluate(minus(2024,2001),23) +| | | | | | Call: evaluate(minus(01,01),V3521) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(minus(01,01),V3522) +| | | | | | Exit: evaluate(minus(01,01),0) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3523) +| | | | | | Exit: evaluate(plus(imul(31,0),0),0) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3500) +| | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) +| | | | | Exit: get_date_diff(C_D,DOB,Age) +| | | | | Call: yearly_visit_limit(outpatient_surgical_services,23,V3511) +| | | | | | Call: yearly_visit_limit(outpatient_surgical_services,V3524,V3525,V3511) +| | | | | | Fail: yearly_visit_limit(outpatient_surgical_services,V3524,V3525,V3511) +| | | | | Fail: yearly_visit_limit(outpatient_surgical_services,23,V3511) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3500) +| | | | | Redo: claim.time(claim13,V3498,V3499) +| | | | | Fail: claim.time(claim13,V3498,V3499) +| | | | | Redo: person.dob(person4,V3497) +| | | | | Fail: person.dob(person4,V3497) +| | | | | Redo: claim.claimant(claim13,V3496) +| | | | | Fail: claim.claimant(claim13,V3496) +| | | | Fail: check_policy_year_limit(claim13,outpatient_surgical_services) +| | | | Call: covered_list_with_location(V3526) +| | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Call: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Fail: member(outpatient_surgical_services,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) +| | | | Redo: covered_list_with_location(V3526) +| | | | Fail: covered_list_with_location(V3526) +| | | | Call: covered_list_with_service_provider(V3527) +| | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) +| | | | Call: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Fail: member(outpatient_surgical_services,[abortion,voluntary_sterilization_reversal]) +| | | | Redo: covered_list_with_service_provider(V3527) +| | | | Fail: covered_list_with_service_provider(V3527) +| | | | Call: covered_list(V3528) +| | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Call: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Fail: member(outpatient_surgical_services,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) +| | | | Redo: covered_list(V3528) +| | | | Fail: covered_list(V3528) +| | | | Call: claim.location(claim13,V3529) +| | | | Exit: claim.location(claim13,outpatient_dept) +| | | | Call: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Exit: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Call: claim.service_provider(claim13,V3530) +| | | | Exit: claim.service_provider(claim13,other) +| | | | Call: valid_service_provider(outpatient_surgical_services,other) +| | | | Fail: valid_service_provider(outpatient_surgical_services,other) +| | | | Redo: claim.service_provider(claim13,V3530) +| | | | Fail: claim.service_provider(claim13,V3530) +| | | | Redo: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Fail: valid_location(outpatient_surgical_services,outpatient_dept) +| | | | Redo: claim.location(claim13,V3529) +| | | | Fail: claim.location(claim13,V3529) +| | | Fail: eligible_service(claim13,policy1,outpatient_surgical_services) +| | | Redo: claim.reason(claim13,V3495) +| | | Fail: claim.reason(claim13,V3495) +| | | Redo: valid_hospital(stanford_medical_center) +| | | Fail: valid_hospital(stanford_medical_center) +| | | Redo: claim.hospital(claim13,V3494) +| | | Fail: claim.hospital(claim13,V3494) +| | | Call: claim.reason(claim13,emergency_room) +| | | Fail: claim.reason(claim13,emergency_room) +| | Fail: valid_hospitalization(claim13,policy1) +| | Redo: policy_active(C,P) +| | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) +| | | Fail: get_timestamp_from_date(01_08_2023,V3343) +| | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) +| | | Fail: get_timestamp_from_date(30_06_2024,V3339) +| | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3335) +| | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) +| | | Fail: get_timestamp_from_date(02_09_2023,V3331) +| | | Redo: policy.enddate(policy1,person4,V3330) +| | | Fail: policy.enddate(policy1,person4,V3330) +| | | Redo: policy.startdate(policy1,person4,V3329) +| | | Fail: policy.startdate(policy1,person4,V3329) +| | | Redo: claim.hosp_end_time(claim13,V3327,V3328) +| | | Fail: claim.hosp_end_time(claim13,V3327,V3328) +| | | Redo: claim.hosp_start_time(claim13,V3325,V3326) +| | | Fail: claim.hosp_start_time(claim13,V3325,V3326) +| | | Redo: claim.claimant(claim13,V3324) +| | | Fail: claim.claimant(claim13,V3324) +| | Fail: policy_active(claim13,policy1) | | Redo: valid_insuree(C,P) -| | | Redo: policy.insuree(policy1,person3) -| | | Fail: policy.insuree(policy1,person3) -| | | Redo: claim.claimant(claim5,V3) -| | | Fail: claim.claimant(claim5,V3) -| | Fail: valid_insuree(claim5,policy1) -| Fail: covered_under_policy(claim5,policy1,cardinal) -| Redo: policy.type(policy1,V2) -| Fail: policy.type(policy1,V2) -| Redo: claim.policy(X,V1) -| Fail: claim.policy(X,V1) +| | | Redo: policy.insuree(policy1,person4) +| | | Fail: policy.insuree(policy1,person4) +| | | Redo: claim.claimant(claim13,V3116) +| | | Fail: claim.claimant(claim13,V3116) +| | Fail: valid_insuree(claim13,policy1) +| Fail: covered_under_policy(claim13,policy1,cardinal) +| Redo: policy.type(policy1,V1854) +| Fail: policy.type(policy1,V1854) +| Redo: claim.policy(X,V1853) +| Fail: claim.policy(X,V1853) Fail: covered(X) +====== Verbose Output for test: Test test_cases_outpatient_surgical_services.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim12' ] +RESULTS: [ 'claim12' ] +===== TEST SUCCEEDED: Test test_cases_outpatient_surgical_services.hdf===== Expected Result: [ 'claim3' ] Call: covered(X) -| Call: claim.policy(X,V52) +| Call: claim.policy(X,V3531) | Exit: claim.policy(claim3,policy1) -| Call: policy.type(policy1,V53) +| Call: policy.type(policy1,V3532) | Exit: policy.type(policy1,cardinal) | Call: covered_under_policy(claim3,policy1,cardinal) | | Call: valid_insuree(claim3,policy1) -| | | Call: claim.claimant(claim3,V54) +| | | Call: claim.claimant(claim3,V3533) | | | Exit: claim.claimant(claim3,person2) | | | Call: policy.insuree(policy1,person2) | | | Exit: policy.insuree(policy1,person2) | | Exit: valid_insuree(C,P) | | Call: policy_active(claim3,policy1) -| | | Call: claim.claimant(claim3,V55) +| | | Call: claim.claimant(claim3,V3534) | | | Exit: claim.claimant(claim3,person2) -| | | Call: claim.hosp_start_time(claim3,V56,V57) +| | | Call: claim.hosp_start_time(claim3,V3535,V3536) | | | Exit: claim.hosp_start_time(claim3,02_09_2023,00_00) -| | | Call: claim.hosp_end_time(claim3,V58,V59) +| | | Call: claim.hosp_end_time(claim3,V3537,V3538) | | | Exit: claim.hosp_end_time(claim3,02_09_2023,01_13) -| | | Call: policy.startdate(policy1,person2,V60) +| | | Call: policy.startdate(policy1,person2,V3539) | | | Exit: policy.startdate(policy1,person2,01_08_2023) -| | | Call: policy.enddate(policy1,person2,V61) +| | | Call: policy.enddate(policy1,person2,V3540) | | | Exit: policy.enddate(policy1,person2,30_06_2024) -| | | Call: get_timestamp_from_date(02_09_2023,V62) -| | | | Call: evaluate(parsedate(02_09_2023),[V63,V64,V65]) +| | | Call: get_timestamp_from_date(02_09_2023,V3541) +| | | | Call: evaluate(parsedate(02_09_2023),[V3542,V3543,V3544]) | | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) -| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V62) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3541) | | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) | | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) -| | | Call: get_timestamp_from_date(02_09_2023,V66) -| | | | Call: evaluate(parsedate(02_09_2023),[V67,V68,V69]) +| | | Call: get_timestamp_from_date(02_09_2023,V3545) +| | | | Call: evaluate(parsedate(02_09_2023),[V3546,V3547,V3548]) | | | | Exit: evaluate(parsedate(02_09_2023),[02,09,2023]) -| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V66) +| | | | Call: evaluate(maketimestamp(2023,09,02,0,0,0),V3545) | | | | Exit: evaluate(maketimestamp(2023,09,02,0,0,0),1693638000000) | | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) -| | | Call: get_timestamp_from_date(30_06_2024,V70) -| | | | Call: evaluate(parsedate(30_06_2024),[V71,V72,V73]) +| | | Call: get_timestamp_from_date(30_06_2024,V3549) +| | | | Call: evaluate(parsedate(30_06_2024),[V3550,V3551,V3552]) | | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) -| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V70) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3549) | | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) | | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) -| | | Call: get_timestamp_from_date(01_08_2023,V74) -| | | | Call: evaluate(parsedate(01_08_2023),[V75,V76,V77]) +| | | Call: get_timestamp_from_date(01_08_2023,V3553) +| | | | Call: evaluate(parsedate(01_08_2023),[V3554,V3555,V3556]) | | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) -| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V74) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3553) | | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) | | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) | | | Call: leq(1690873200000,1693638000000) @@ -242,70 +12675,70 @@ Call: covered(X) | | | Exit: leq(1693638000000,1719730800000) | | Exit: policy_active(C,P) | | Call: valid_hospitalization(claim3,policy1) -| | | Call: claim.hospital(claim3,V78) +| | | Call: claim.hospital(claim3,V3557) | | | Exit: claim.hospital(claim3,stanford_medical_center) | | | Call: valid_hospital(stanford_medical_center) | | | Exit: valid_hospital(stanford_medical_center) -| | | Call: claim.reason(claim3,V79) +| | | Call: claim.reason(claim3,V3558) | | | Exit: claim.reason(claim3,routine_physical) | | | Call: eligible_service(claim3,policy1,routine_physical) | | | | Call: check_policy_year_limit(claim3,routine_physical) -| | | | | Call: claim.claimant(claim3,V80) +| | | | | Call: claim.claimant(claim3,V3559) | | | | | Exit: claim.claimant(claim3,person2) -| | | | | Call: person.dob(person2,V81) +| | | | | Call: person.dob(person2,V3560) | | | | | Exit: person.dob(person2,01_01_2001) -| | | | | Call: claim.time(claim3,V82,V83) +| | | | | Call: claim.time(claim3,V3561,V3562) | | | | | Exit: claim.time(claim3,01_01_2024,00_00) -| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V84) -| | | | | | Call: evaluate(parsedate(01_01_2024),[V85,V86,V87]) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3563) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3564,V3565,V3566]) | | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) -| | | | | | Call: evaluate(parsedate(01_01_2001),[V88,V89,V90]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3567,V3568,V3569]) | | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) -| | | | | | Call: evaluate(minus(2024,2001),V91) +| | | | | | Call: evaluate(minus(2024,2001),V3570) | | | | | | Exit: evaluate(minus(2024,2001),23) -| | | | | | Call: evaluate(minus(01,01),V92) +| | | | | | Call: evaluate(minus(01,01),V3571) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(minus(01,01),V93) +| | | | | | Call: evaluate(minus(01,01),V3572) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(plus(imul(31,0),0),V94) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3573) | | | | | | Exit: evaluate(plus(imul(31,0),0),0) -| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V84) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3563) | | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) | | | | | Exit: get_date_diff(C_D,DOB,Age) -| | | | | Call: yearly_visit_limit(routine_physical,23,V95) -| | | | | | Call: yearly_visit_limit(routine_physical,V96,V97,V95) +| | | | | Call: yearly_visit_limit(routine_physical,23,V3574) +| | | | | | Call: yearly_visit_limit(routine_physical,V3575,V3576,V3574) | | | | | | Exit: yearly_visit_limit(routine_physical,0,22,0) -| | | | | | Call: evaluate(minus(22,1),V98) +| | | | | | Call: evaluate(minus(22,1),V3577) | | | | | | Exit: evaluate(minus(22,1),21) | | | | | | Call: leq(23,21) | | | | | | Fail: leq(23,21) -| | | | | | Redo: yearly_visit_limit(routine_physical,V96,V97,V95) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3575,V3576,V3574) | | | | | | Exit: yearly_visit_limit(routine_physical,22,200,1) -| | | | | | Call: evaluate(minus(200,1),V98) +| | | | | | Call: evaluate(minus(200,1),V3577) | | | | | | Exit: evaluate(minus(200,1),199) | | | | | | Call: leq(23,199) | | | | | | Exit: leq(23,199) | | | | | | Call: leq(22,23) | | | | | | Exit: leq(22,23) | | | | | Exit: yearly_visit_limit(Service,Age,Limit) -| | | | | Call: evaluate(plus(countofall(V99,visit_current_year(routine_physical,claim3,V99)),1),V100) -| | | | | Exit: evaluate(plus(countofall(V102,visit_current_year(routine_physical,claim3,V102)),1),1) +| | | | | Call: evaluate(plus(countofall(V3578,visit_current_year(routine_physical,claim3,V3578)),1),V3579) +| | | | | Exit: evaluate(plus(countofall(V3581,visit_current_year(routine_physical,claim3,V3581)),1),1) | | | | | Call: leq(1,1) | | | | | Exit: leq(1,1) | | | | Exit: check_policy_year_limit(C,Service) -| | | | Call: claim.location(claim3,V103) +| | | | Call: claim.location(claim3,V3582) | | | | Exit: claim.location(claim3,phys_office) | | | | Call: valid_location(routine_physical,phys_office) | | | | Exit: valid_location(routine_physical,phys_office) | | | Exit: eligible_service(C,P,R) | | | Call: ~exception(claim3,policy1) Call: exception(claim3,policy1) -| Call: claim.claimant(claim3,V104) +| Call: claim.claimant(claim3,V3583) | Exit: claim.claimant(claim3,person2) | Call: person.occupation(person2,armed_forces) | Fail: person.occupation(person2,armed_forces) -| Redo: claim.claimant(claim3,V104) -| Fail: claim.claimant(claim3,V104) +| Redo: claim.claimant(claim3,V3583) +| Fail: claim.claimant(claim3,V3583) | Call: claim.reason(claim3,home_health_care) | Fail: claim.reason(claim3,home_health_care) | Call: claim.reason(claim3,home_health_care) @@ -321,71 +12754,71 @@ Redo: covered(X) | | | Redo: eligible_service(C,P,R) | | | | Redo: valid_location(routine_physical,phys_office) | | | | Fail: valid_location(routine_physical,phys_office) -| | | | Redo: claim.location(claim3,V103) -| | | | Fail: claim.location(claim3,V103) +| | | | Redo: claim.location(claim3,V3582) +| | | | Fail: claim.location(claim3,V3582) | | | | Redo: check_policy_year_limit(C,Service) | | | | | Redo: yearly_visit_limit(Service,Age,Limit) -| | | | | | Redo: yearly_visit_limit(routine_physical,V96,V97,V95) -| | | | | | Fail: yearly_visit_limit(routine_physical,V96,V97,V95) -| | | | | Fail: yearly_visit_limit(routine_physical,23,V95) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3575,V3576,V3574) +| | | | | | Fail: yearly_visit_limit(routine_physical,V3575,V3576,V3574) +| | | | | Fail: yearly_visit_limit(routine_physical,23,V3574) | | | | | Redo: get_date_diff(C_D,DOB,Age) -| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V84) -| | | | | Redo: claim.time(claim3,V82,V83) -| | | | | Fail: claim.time(claim3,V82,V83) -| | | | | Redo: person.dob(person2,V81) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3563) +| | | | | Redo: claim.time(claim3,V3561,V3562) +| | | | | Fail: claim.time(claim3,V3561,V3562) +| | | | | Redo: person.dob(person2,V3560) | | | | | Exit: person.dob(person2,01_01_2001) -| | | | | Call: claim.time(claim3,V82,V83) +| | | | | Call: claim.time(claim3,V3561,V3562) | | | | | Exit: claim.time(claim3,01_01_2024,00_00) -| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V84) -| | | | | | Call: evaluate(parsedate(01_01_2024),[V105,V106,V107]) +| | | | | Call: get_date_diff(01_01_2024,01_01_2001,V3563) +| | | | | | Call: evaluate(parsedate(01_01_2024),[V3584,V3585,V3586]) | | | | | | Exit: evaluate(parsedate(01_01_2024),[01,01,2024]) -| | | | | | Call: evaluate(parsedate(01_01_2001),[V108,V109,V110]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3587,V3588,V3589]) | | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) -| | | | | | Call: evaluate(minus(2024,2001),V111) +| | | | | | Call: evaluate(minus(2024,2001),V3590) | | | | | | Exit: evaluate(minus(2024,2001),23) -| | | | | | Call: evaluate(minus(01,01),V112) +| | | | | | Call: evaluate(minus(01,01),V3591) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(minus(01,01),V113) +| | | | | | Call: evaluate(minus(01,01),V3592) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(plus(imul(31,0),0),V114) +| | | | | | Call: evaluate(plus(imul(31,0),0),V3593) | | | | | | Exit: evaluate(plus(imul(31,0),0),0) -| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V84) +| | | | | | Call: evaluate(plus(23,if(leq(0,-1),-1,true,0)),V3563) | | | | | | Exit: evaluate(plus(23,if(leq(0,-1),-1,true,0)),23) | | | | | Exit: get_date_diff(C_D,DOB,Age) -| | | | | Call: yearly_visit_limit(routine_physical,23,V95) -| | | | | | Call: yearly_visit_limit(routine_physical,V115,V116,V95) +| | | | | Call: yearly_visit_limit(routine_physical,23,V3574) +| | | | | | Call: yearly_visit_limit(routine_physical,V3594,V3595,V3574) | | | | | | Exit: yearly_visit_limit(routine_physical,0,22,0) -| | | | | | Call: evaluate(minus(22,1),V117) +| | | | | | Call: evaluate(minus(22,1),V3596) | | | | | | Exit: evaluate(minus(22,1),21) | | | | | | Call: leq(23,21) | | | | | | Fail: leq(23,21) -| | | | | | Redo: yearly_visit_limit(routine_physical,V115,V116,V95) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3594,V3595,V3574) | | | | | | Exit: yearly_visit_limit(routine_physical,22,200,1) -| | | | | | Call: evaluate(minus(200,1),V117) +| | | | | | Call: evaluate(minus(200,1),V3596) | | | | | | Exit: evaluate(minus(200,1),199) | | | | | | Call: leq(23,199) | | | | | | Exit: leq(23,199) | | | | | | Call: leq(22,23) | | | | | | Exit: leq(22,23) | | | | | Exit: yearly_visit_limit(Service,Age,Limit) -| | | | | Call: evaluate(plus(countofall(V102,visit_current_year(routine_physical,claim3,V102)),1),V100) -| | | | | Exit: evaluate(plus(countofall(V119,visit_current_year(routine_physical,claim3,V119)),1),1) +| | | | | Call: evaluate(plus(countofall(V3581,visit_current_year(routine_physical,claim3,V3581)),1),V3579) +| | | | | Exit: evaluate(plus(countofall(V3598,visit_current_year(routine_physical,claim3,V3598)),1),1) | | | | | Call: leq(1,1) | | | | | Exit: leq(1,1) | | | | Exit: check_policy_year_limit(C,Service) -| | | | Call: claim.location(claim3,V103) +| | | | Call: claim.location(claim3,V3582) | | | | Exit: claim.location(claim3,phys_office) | | | | Call: valid_location(routine_physical,phys_office) | | | | Exit: valid_location(routine_physical,phys_office) | | | Exit: eligible_service(C,P,R) | | | Call: ~exception(claim3,policy1) Call: exception(claim3,policy1) -| Call: claim.claimant(claim3,V120) +| Call: claim.claimant(claim3,V3599) | Exit: claim.claimant(claim3,person2) | Call: person.occupation(person2,armed_forces) | Fail: person.occupation(person2,armed_forces) -| Redo: claim.claimant(claim3,V120) -| Fail: claim.claimant(claim3,V120) +| Redo: claim.claimant(claim3,V3599) +| Fail: claim.claimant(claim3,V3599) | Call: claim.reason(claim3,home_health_care) | Fail: claim.reason(claim3,home_health_care) | Call: claim.reason(claim3,home_health_care) @@ -401,123 +12834,123 @@ Redo: covered(X) | | | Redo: eligible_service(C,P,R) | | | | Redo: valid_location(routine_physical,phys_office) | | | | Fail: valid_location(routine_physical,phys_office) -| | | | Redo: claim.location(claim3,V103) -| | | | Fail: claim.location(claim3,V103) +| | | | Redo: claim.location(claim3,V3582) +| | | | Fail: claim.location(claim3,V3582) | | | | Redo: check_policy_year_limit(C,Service) | | | | | Redo: yearly_visit_limit(Service,Age,Limit) -| | | | | | Redo: yearly_visit_limit(routine_physical,V115,V116,V95) -| | | | | | Fail: yearly_visit_limit(routine_physical,V115,V116,V95) -| | | | | Fail: yearly_visit_limit(routine_physical,23,V95) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3594,V3595,V3574) +| | | | | | Fail: yearly_visit_limit(routine_physical,V3594,V3595,V3574) +| | | | | Fail: yearly_visit_limit(routine_physical,23,V3574) | | | | | Redo: get_date_diff(C_D,DOB,Age) -| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V84) -| | | | | Redo: claim.time(claim3,V82,V83) -| | | | | Fail: claim.time(claim3,V82,V83) -| | | | | Redo: person.dob(person2,V81) -| | | | | Fail: person.dob(person2,V81) -| | | | | Redo: claim.claimant(claim3,V80) -| | | | | Fail: claim.claimant(claim3,V80) +| | | | | Fail: get_date_diff(01_01_2024,01_01_2001,V3563) +| | | | | Redo: claim.time(claim3,V3561,V3562) +| | | | | Fail: claim.time(claim3,V3561,V3562) +| | | | | Redo: person.dob(person2,V3560) +| | | | | Fail: person.dob(person2,V3560) +| | | | | Redo: claim.claimant(claim3,V3559) +| | | | | Fail: claim.claimant(claim3,V3559) | | | | Fail: check_policy_year_limit(claim3,routine_physical) -| | | | Call: covered_list_with_location(V121) +| | | | Call: covered_list_with_location(V3600) | | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) | | | | Call: member(routine_physical,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) | | | | Fail: member(routine_physical,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Redo: covered_list_with_location(V121) -| | | | Fail: covered_list_with_location(V121) -| | | | Call: covered_list_with_service_provider(V122) +| | | | Redo: covered_list_with_location(V3600) +| | | | Fail: covered_list_with_location(V3600) +| | | | Call: covered_list_with_service_provider(V3601) | | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) | | | | Call: member(routine_physical,[abortion,voluntary_sterilization_reversal]) | | | | Fail: member(routine_physical,[abortion,voluntary_sterilization_reversal]) -| | | | Redo: covered_list_with_service_provider(V122) -| | | | Fail: covered_list_with_service_provider(V122) -| | | | Call: covered_list(V123) +| | | | Redo: covered_list_with_service_provider(V3601) +| | | | Fail: covered_list_with_service_provider(V3601) +| | | | Call: covered_list(V3602) | | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) | | | | Call: member(routine_physical,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) | | | | Fail: member(routine_physical,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) -| | | | Redo: covered_list(V123) -| | | | Fail: covered_list(V123) +| | | | Redo: covered_list(V3602) +| | | | Fail: covered_list(V3602) | | | Fail: eligible_service(claim3,policy1,routine_physical) -| | | Redo: claim.reason(claim3,V79) -| | | Fail: claim.reason(claim3,V79) +| | | Redo: claim.reason(claim3,V3558) +| | | Fail: claim.reason(claim3,V3558) | | | Redo: valid_hospital(stanford_medical_center) | | | Fail: valid_hospital(stanford_medical_center) -| | | Redo: claim.hospital(claim3,V78) -| | | Fail: claim.hospital(claim3,V78) +| | | Redo: claim.hospital(claim3,V3557) +| | | Fail: claim.hospital(claim3,V3557) | | | Call: claim.reason(claim3,emergency_room) | | | Fail: claim.reason(claim3,emergency_room) | | Fail: valid_hospitalization(claim3,policy1) | | Redo: policy_active(C,P) | | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) -| | | Fail: get_timestamp_from_date(01_08_2023,V74) +| | | Fail: get_timestamp_from_date(01_08_2023,V3553) | | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) -| | | Fail: get_timestamp_from_date(30_06_2024,V70) +| | | Fail: get_timestamp_from_date(30_06_2024,V3549) | | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) -| | | Fail: get_timestamp_from_date(02_09_2023,V66) +| | | Fail: get_timestamp_from_date(02_09_2023,V3545) | | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) -| | | Fail: get_timestamp_from_date(02_09_2023,V62) -| | | Redo: policy.enddate(policy1,person2,V61) -| | | Fail: policy.enddate(policy1,person2,V61) -| | | Redo: policy.startdate(policy1,person2,V60) -| | | Fail: policy.startdate(policy1,person2,V60) -| | | Redo: claim.hosp_end_time(claim3,V58,V59) -| | | Fail: claim.hosp_end_time(claim3,V58,V59) -| | | Redo: claim.hosp_start_time(claim3,V56,V57) -| | | Fail: claim.hosp_start_time(claim3,V56,V57) -| | | Redo: claim.claimant(claim3,V55) -| | | Fail: claim.claimant(claim3,V55) +| | | Fail: get_timestamp_from_date(02_09_2023,V3541) +| | | Redo: policy.enddate(policy1,person2,V3540) +| | | Fail: policy.enddate(policy1,person2,V3540) +| | | Redo: policy.startdate(policy1,person2,V3539) +| | | Fail: policy.startdate(policy1,person2,V3539) +| | | Redo: claim.hosp_end_time(claim3,V3537,V3538) +| | | Fail: claim.hosp_end_time(claim3,V3537,V3538) +| | | Redo: claim.hosp_start_time(claim3,V3535,V3536) +| | | Fail: claim.hosp_start_time(claim3,V3535,V3536) +| | | Redo: claim.claimant(claim3,V3534) +| | | Fail: claim.claimant(claim3,V3534) | | Fail: policy_active(claim3,policy1) | | Redo: valid_insuree(C,P) | | | Redo: policy.insuree(policy1,person2) | | | Fail: policy.insuree(policy1,person2) -| | | Redo: claim.claimant(claim3,V54) -| | | Fail: claim.claimant(claim3,V54) +| | | Redo: claim.claimant(claim3,V3533) +| | | Fail: claim.claimant(claim3,V3533) | | Fail: valid_insuree(claim3,policy1) | Fail: covered_under_policy(claim3,policy1,cardinal) -| Redo: policy.type(policy1,V53) -| Fail: policy.type(policy1,V53) -| Redo: claim.policy(X,V52) +| Redo: policy.type(policy1,V3532) +| Fail: policy.type(policy1,V3532) +| Redo: claim.policy(X,V3531) | Exit: claim.policy(claim4,policy1) -| Call: policy.type(policy1,V53) +| Call: policy.type(policy1,V3532) | Exit: policy.type(policy1,cardinal) | Call: covered_under_policy(claim4,policy1,cardinal) | | Call: valid_insuree(claim4,policy1) -| | | Call: claim.claimant(claim4,V124) +| | | Call: claim.claimant(claim4,V3603) | | | Exit: claim.claimant(claim4,person2) | | | Call: policy.insuree(policy1,person2) | | | Exit: policy.insuree(policy1,person2) | | Exit: valid_insuree(C,P) | | Call: policy_active(claim4,policy1) -| | | Call: claim.claimant(claim4,V125) +| | | Call: claim.claimant(claim4,V3604) | | | Exit: claim.claimant(claim4,person2) -| | | Call: claim.hosp_start_time(claim4,V126,V127) +| | | Call: claim.hosp_start_time(claim4,V3605,V3606) | | | Exit: claim.hosp_start_time(claim4,02_08_2023,00_00) -| | | Call: claim.hosp_end_time(claim4,V128,V129) +| | | Call: claim.hosp_end_time(claim4,V3607,V3608) | | | Exit: claim.hosp_end_time(claim4,02_08_2023,01_13) -| | | Call: policy.startdate(policy1,person2,V130) +| | | Call: policy.startdate(policy1,person2,V3609) | | | Exit: policy.startdate(policy1,person2,01_08_2023) -| | | Call: policy.enddate(policy1,person2,V131) +| | | Call: policy.enddate(policy1,person2,V3610) | | | Exit: policy.enddate(policy1,person2,30_06_2024) -| | | Call: get_timestamp_from_date(02_08_2023,V132) -| | | | Call: evaluate(parsedate(02_08_2023),[V133,V134,V135]) +| | | Call: get_timestamp_from_date(02_08_2023,V3611) +| | | | Call: evaluate(parsedate(02_08_2023),[V3612,V3613,V3614]) | | | | Exit: evaluate(parsedate(02_08_2023),[02,08,2023]) -| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V132) +| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V3611) | | | | Exit: evaluate(maketimestamp(2023,08,02,0,0,0),1690959600000) | | | Exit: get_timestamp_from_date(H_START_DATE,H_START_STAMP) -| | | Call: get_timestamp_from_date(02_08_2023,V136) -| | | | Call: evaluate(parsedate(02_08_2023),[V137,V138,V139]) +| | | Call: get_timestamp_from_date(02_08_2023,V3615) +| | | | Call: evaluate(parsedate(02_08_2023),[V3616,V3617,V3618]) | | | | Exit: evaluate(parsedate(02_08_2023),[02,08,2023]) -| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V136) +| | | | Call: evaluate(maketimestamp(2023,08,02,0,0,0),V3615) | | | | Exit: evaluate(maketimestamp(2023,08,02,0,0,0),1690959600000) | | | Exit: get_timestamp_from_date(H_END_DATE,H_END_STAMP) -| | | Call: get_timestamp_from_date(30_06_2024,V140) -| | | | Call: evaluate(parsedate(30_06_2024),[V141,V142,V143]) +| | | Call: get_timestamp_from_date(30_06_2024,V3619) +| | | | Call: evaluate(parsedate(30_06_2024),[V3620,V3621,V3622]) | | | | Exit: evaluate(parsedate(30_06_2024),[30,06,2024]) -| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V140) +| | | | Call: evaluate(maketimestamp(2024,06,30,0,0,0),V3619) | | | | Exit: evaluate(maketimestamp(2024,06,30,0,0,0),1719730800000) | | | Exit: get_timestamp_from_date(P_END_DATE,P_END_STAMP) -| | | Call: get_timestamp_from_date(01_08_2023,V144) -| | | | Call: evaluate(parsedate(01_08_2023),[V145,V146,V147]) +| | | Call: get_timestamp_from_date(01_08_2023,V3623) +| | | | Call: evaluate(parsedate(01_08_2023),[V3624,V3625,V3626]) | | | | Exit: evaluate(parsedate(01_08_2023),[01,08,2023]) -| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V144) +| | | | Call: evaluate(maketimestamp(2023,08,01,0,0,0),V3623) | | | | Exit: evaluate(maketimestamp(2023,08,01,0,0,0),1690873200000) | | | Exit: get_timestamp_from_date(P_START_DATE,P_START_STAMP) | | | Call: leq(1690873200000,1690959600000) @@ -526,180 +12959,184 @@ Redo: covered(X) | | | Exit: leq(1690959600000,1719730800000) | | Exit: policy_active(C,P) | | Call: valid_hospitalization(claim4,policy1) -| | | Call: claim.hospital(claim4,V148) +| | | Call: claim.hospital(claim4,V3627) | | | Exit: claim.hospital(claim4,stanford_medical_center) | | | Call: valid_hospital(stanford_medical_center) | | | Exit: valid_hospital(stanford_medical_center) -| | | Call: claim.reason(claim4,V149) +| | | Call: claim.reason(claim4,V3628) | | | Exit: claim.reason(claim4,routine_physical) | | | Call: eligible_service(claim4,policy1,routine_physical) | | | | Call: check_policy_year_limit(claim4,routine_physical) -| | | | | Call: claim.claimant(claim4,V150) +| | | | | Call: claim.claimant(claim4,V3629) | | | | | Exit: claim.claimant(claim4,person2) -| | | | | Call: person.dob(person2,V151) +| | | | | Call: person.dob(person2,V3630) | | | | | Exit: person.dob(person2,01_01_2001) -| | | | | Call: claim.time(claim4,V152,V153) +| | | | | Call: claim.time(claim4,V3631,V3632) | | | | | Exit: claim.time(claim4,01_02_2024,00_00) -| | | | | Call: get_date_diff(01_02_2024,01_01_2001,V154) -| | | | | | Call: evaluate(parsedate(01_02_2024),[V155,V156,V157]) +| | | | | Call: get_date_diff(01_02_2024,01_01_2001,V3633) +| | | | | | Call: evaluate(parsedate(01_02_2024),[V3634,V3635,V3636]) | | | | | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) -| | | | | | Call: evaluate(parsedate(01_01_2001),[V158,V159,V160]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3637,V3638,V3639]) | | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) -| | | | | | Call: evaluate(minus(2024,2001),V161) +| | | | | | Call: evaluate(minus(2024,2001),V3640) | | | | | | Exit: evaluate(minus(2024,2001),23) -| | | | | | Call: evaluate(minus(02,01),V162) +| | | | | | Call: evaluate(minus(02,01),V3641) | | | | | | Exit: evaluate(minus(02,01),1) -| | | | | | Call: evaluate(minus(01,01),V163) +| | | | | | Call: evaluate(minus(01,01),V3642) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(plus(imul(31,1),0),V164) +| | | | | | Call: evaluate(plus(imul(31,1),0),V3643) | | | | | | Exit: evaluate(plus(imul(31,1),0),31) -| | | | | | Call: evaluate(plus(23,if(leq(31,-1),-1,true,0)),V154) +| | | | | | Call: evaluate(plus(23,if(leq(31,-1),-1,true,0)),V3633) | | | | | | Exit: evaluate(plus(23,if(leq(31,-1),-1,true,0)),23) | | | | | Exit: get_date_diff(C_D,DOB,Age) -| | | | | Call: yearly_visit_limit(routine_physical,23,V165) -| | | | | | Call: yearly_visit_limit(routine_physical,V166,V167,V165) +| | | | | Call: yearly_visit_limit(routine_physical,23,V3644) +| | | | | | Call: yearly_visit_limit(routine_physical,V3645,V3646,V3644) | | | | | | Exit: yearly_visit_limit(routine_physical,0,22,0) -| | | | | | Call: evaluate(minus(22,1),V168) +| | | | | | Call: evaluate(minus(22,1),V3647) | | | | | | Exit: evaluate(minus(22,1),21) | | | | | | Call: leq(23,21) | | | | | | Fail: leq(23,21) -| | | | | | Redo: yearly_visit_limit(routine_physical,V166,V167,V165) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3645,V3646,V3644) | | | | | | Exit: yearly_visit_limit(routine_physical,22,200,1) -| | | | | | Call: evaluate(minus(200,1),V168) +| | | | | | Call: evaluate(minus(200,1),V3647) | | | | | | Exit: evaluate(minus(200,1),199) | | | | | | Call: leq(23,199) | | | | | | Exit: leq(23,199) | | | | | | Call: leq(22,23) | | | | | | Exit: leq(22,23) | | | | | Exit: yearly_visit_limit(Service,Age,Limit) -| | | | | Call: evaluate(plus(countofall(V169,visit_current_year(routine_physical,claim4,V169)),1),V170) -| | | | | Exit: evaluate(plus(countofall(V172,visit_current_year(routine_physical,claim4,V172)),1),2) +| | | | | Call: evaluate(plus(countofall(V3648,visit_current_year(routine_physical,claim4,V3648)),1),V3649) +| | | | | Exit: evaluate(plus(countofall(V3651,visit_current_year(routine_physical,claim4,V3651)),1),2) | | | | | Call: leq(2,1) | | | | | Fail: leq(2,1) | | | | | Redo: yearly_visit_limit(Service,Age,Limit) -| | | | | | Redo: yearly_visit_limit(routine_physical,V166,V167,V165) -| | | | | | Fail: yearly_visit_limit(routine_physical,V166,V167,V165) -| | | | | Fail: yearly_visit_limit(routine_physical,23,V165) -| | | | | Redo: get_date_diff(C_D,DOB,Age) -| | | | | Fail: get_date_diff(01_02_2024,01_01_2001,V154) -| | | | | Redo: claim.time(claim4,V152,V153) -| | | | | Fail: claim.time(claim4,V152,V153) -| | | | | Redo: person.dob(person2,V151) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3645,V3646,V3644) +| | | | | | Fail: yearly_visit_limit(routine_physical,V3645,V3646,V3644) +| | | | | Fail: yearly_visit_limit(routine_physical,23,V3644) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_02_2024,01_01_2001,V3633) +| | | | | Redo: claim.time(claim4,V3631,V3632) +| | | | | Fail: claim.time(claim4,V3631,V3632) +| | | | | Redo: person.dob(person2,V3630) | | | | | Exit: person.dob(person2,01_01_2001) -| | | | | Call: claim.time(claim4,V152,V153) +| | | | | Call: claim.time(claim4,V3631,V3632) | | | | | Exit: claim.time(claim4,01_02_2024,00_00) -| | | | | Call: get_date_diff(01_02_2024,01_01_2001,V154) -| | | | | | Call: evaluate(parsedate(01_02_2024),[V173,V174,V175]) +| | | | | Call: get_date_diff(01_02_2024,01_01_2001,V3633) +| | | | | | Call: evaluate(parsedate(01_02_2024),[V3652,V3653,V3654]) | | | | | | Exit: evaluate(parsedate(01_02_2024),[01,02,2024]) -| | | | | | Call: evaluate(parsedate(01_01_2001),[V176,V177,V178]) +| | | | | | Call: evaluate(parsedate(01_01_2001),[V3655,V3656,V3657]) | | | | | | Exit: evaluate(parsedate(01_01_2001),[01,01,2001]) -| | | | | | Call: evaluate(minus(2024,2001),V179) +| | | | | | Call: evaluate(minus(2024,2001),V3658) | | | | | | Exit: evaluate(minus(2024,2001),23) -| | | | | | Call: evaluate(minus(02,01),V180) +| | | | | | Call: evaluate(minus(02,01),V3659) | | | | | | Exit: evaluate(minus(02,01),1) -| | | | | | Call: evaluate(minus(01,01),V181) +| | | | | | Call: evaluate(minus(01,01),V3660) | | | | | | Exit: evaluate(minus(01,01),0) -| | | | | | Call: evaluate(plus(imul(31,1),0),V182) +| | | | | | Call: evaluate(plus(imul(31,1),0),V3661) | | | | | | Exit: evaluate(plus(imul(31,1),0),31) -| | | | | | Call: evaluate(plus(23,if(leq(31,-1),-1,true,0)),V154) +| | | | | | Call: evaluate(plus(23,if(leq(31,-1),-1,true,0)),V3633) | | | | | | Exit: evaluate(plus(23,if(leq(31,-1),-1,true,0)),23) | | | | | Exit: get_date_diff(C_D,DOB,Age) -| | | | | Call: yearly_visit_limit(routine_physical,23,V165) -| | | | | | Call: yearly_visit_limit(routine_physical,V183,V184,V165) +| | | | | Call: yearly_visit_limit(routine_physical,23,V3644) +| | | | | | Call: yearly_visit_limit(routine_physical,V3662,V3663,V3644) | | | | | | Exit: yearly_visit_limit(routine_physical,0,22,0) -| | | | | | Call: evaluate(minus(22,1),V185) +| | | | | | Call: evaluate(minus(22,1),V3664) | | | | | | Exit: evaluate(minus(22,1),21) | | | | | | Call: leq(23,21) | | | | | | Fail: leq(23,21) -| | | | | | Redo: yearly_visit_limit(routine_physical,V183,V184,V165) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3662,V3663,V3644) | | | | | | Exit: yearly_visit_limit(routine_physical,22,200,1) -| | | | | | Call: evaluate(minus(200,1),V185) +| | | | | | Call: evaluate(minus(200,1),V3664) | | | | | | Exit: evaluate(minus(200,1),199) | | | | | | Call: leq(23,199) | | | | | | Exit: leq(23,199) | | | | | | Call: leq(22,23) | | | | | | Exit: leq(22,23) | | | | | Exit: yearly_visit_limit(Service,Age,Limit) -| | | | | Call: evaluate(plus(countofall(V172,visit_current_year(routine_physical,claim4,V172)),1),V170) -| | | | | Exit: evaluate(plus(countofall(V187,visit_current_year(routine_physical,claim4,V187)),1),2) +| | | | | Call: evaluate(plus(countofall(V3651,visit_current_year(routine_physical,claim4,V3651)),1),V3649) +| | | | | Exit: evaluate(plus(countofall(V3666,visit_current_year(routine_physical,claim4,V3666)),1),2) | | | | | Call: leq(2,1) | | | | | Fail: leq(2,1) | | | | | Redo: yearly_visit_limit(Service,Age,Limit) -| | | | | | Redo: yearly_visit_limit(routine_physical,V183,V184,V165) -| | | | | | Fail: yearly_visit_limit(routine_physical,V183,V184,V165) -| | | | | Fail: yearly_visit_limit(routine_physical,23,V165) -| | | | | Redo: get_date_diff(C_D,DOB,Age) -| | | | | Fail: get_date_diff(01_02_2024,01_01_2001,V154) -| | | | | Redo: claim.time(claim4,V152,V153) -| | | | | Fail: claim.time(claim4,V152,V153) -| | | | | Redo: person.dob(person2,V151) -| | | | | Fail: person.dob(person2,V151) -| | | | | Redo: claim.claimant(claim4,V150) -| | | | | Fail: claim.claimant(claim4,V150) +| | | | | | Redo: yearly_visit_limit(routine_physical,V3662,V3663,V3644) +| | | | | | Fail: yearly_visit_limit(routine_physical,V3662,V3663,V3644) +| | | | | Fail: yearly_visit_limit(routine_physical,23,V3644) +| | | | | Redo: get_date_diff(C_D,DOB,Age) +| | | | | Fail: get_date_diff(01_02_2024,01_01_2001,V3633) +| | | | | Redo: claim.time(claim4,V3631,V3632) +| | | | | Fail: claim.time(claim4,V3631,V3632) +| | | | | Redo: person.dob(person2,V3630) +| | | | | Fail: person.dob(person2,V3630) +| | | | | Redo: claim.claimant(claim4,V3629) +| | | | | Fail: claim.claimant(claim4,V3629) | | | | Fail: check_policy_year_limit(claim4,routine_physical) -| | | | Call: covered_list_with_location(V188) +| | | | Call: covered_list_with_location(V3667) | | | | Exit: covered_list_with_location([physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) | | | | Call: member(routine_physical,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) | | | | Fail: member(routine_physical,[physician_consultation,allergy,inpatient_care,non_surgical_physican_service,inpatient_surgical_services,well_newborn_nursery_care,home_health_care]) -| | | | Redo: covered_list_with_location(V188) -| | | | Fail: covered_list_with_location(V188) -| | | | Call: covered_list_with_service_provider(V189) +| | | | Redo: covered_list_with_location(V3667) +| | | | Fail: covered_list_with_location(V3667) +| | | | Call: covered_list_with_service_provider(V3668) | | | | Exit: covered_list_with_service_provider([abortion,voluntary_sterilization_reversal]) | | | | Call: member(routine_physical,[abortion,voluntary_sterilization_reversal]) | | | | Fail: member(routine_physical,[abortion,voluntary_sterilization_reversal]) -| | | | Redo: covered_list_with_service_provider(V189) -| | | | Fail: covered_list_with_service_provider(V189) -| | | | Call: covered_list(V190) +| | | | Redo: covered_list_with_service_provider(V3668) +| | | | Fail: covered_list_with_service_provider(V3668) +| | | | Call: covered_list(V3669) | | | | Exit: covered_list([breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) | | | | Call: member(routine_physical,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) | | | | Fail: member(routine_physical,[breast_pump_supplies,hospice,skilled_nursing,skilled_nursing,maternity_care]) -| | | | Redo: covered_list(V190) -| | | | Fail: covered_list(V190) +| | | | Redo: covered_list(V3669) +| | | | Fail: covered_list(V3669) | | | Fail: eligible_service(claim4,policy1,routine_physical) -| | | Redo: claim.reason(claim4,V149) -| | | Fail: claim.reason(claim4,V149) +| | | Redo: claim.reason(claim4,V3628) +| | | Fail: claim.reason(claim4,V3628) | | | Redo: valid_hospital(stanford_medical_center) | | | Fail: valid_hospital(stanford_medical_center) -| | | Redo: claim.hospital(claim4,V148) -| | | Fail: claim.hospital(claim4,V148) +| | | Redo: claim.hospital(claim4,V3627) +| | | Fail: claim.hospital(claim4,V3627) | | | Call: claim.reason(claim4,emergency_room) | | | Fail: claim.reason(claim4,emergency_room) | | Fail: valid_hospitalization(claim4,policy1) | | Redo: policy_active(C,P) | | | Redo: get_timestamp_from_date(P_START_DATE,P_START_STAMP) -| | | Fail: get_timestamp_from_date(01_08_2023,V144) +| | | Fail: get_timestamp_from_date(01_08_2023,V3623) | | | Redo: get_timestamp_from_date(P_END_DATE,P_END_STAMP) -| | | Fail: get_timestamp_from_date(30_06_2024,V140) +| | | Fail: get_timestamp_from_date(30_06_2024,V3619) | | | Redo: get_timestamp_from_date(H_END_DATE,H_END_STAMP) -| | | Fail: get_timestamp_from_date(02_08_2023,V136) +| | | Fail: get_timestamp_from_date(02_08_2023,V3615) | | | Redo: get_timestamp_from_date(H_START_DATE,H_START_STAMP) -| | | Fail: get_timestamp_from_date(02_08_2023,V132) -| | | Redo: policy.enddate(policy1,person2,V131) -| | | Fail: policy.enddate(policy1,person2,V131) -| | | Redo: policy.startdate(policy1,person2,V130) -| | | Fail: policy.startdate(policy1,person2,V130) -| | | Redo: claim.hosp_end_time(claim4,V128,V129) -| | | Fail: claim.hosp_end_time(claim4,V128,V129) -| | | Redo: claim.hosp_start_time(claim4,V126,V127) -| | | Fail: claim.hosp_start_time(claim4,V126,V127) -| | | Redo: claim.claimant(claim4,V125) -| | | Fail: claim.claimant(claim4,V125) +| | | Fail: get_timestamp_from_date(02_08_2023,V3611) +| | | Redo: policy.enddate(policy1,person2,V3610) +| | | Fail: policy.enddate(policy1,person2,V3610) +| | | Redo: policy.startdate(policy1,person2,V3609) +| | | Fail: policy.startdate(policy1,person2,V3609) +| | | Redo: claim.hosp_end_time(claim4,V3607,V3608) +| | | Fail: claim.hosp_end_time(claim4,V3607,V3608) +| | | Redo: claim.hosp_start_time(claim4,V3605,V3606) +| | | Fail: claim.hosp_start_time(claim4,V3605,V3606) +| | | Redo: claim.claimant(claim4,V3604) +| | | Fail: claim.claimant(claim4,V3604) | | Fail: policy_active(claim4,policy1) | | Redo: valid_insuree(C,P) | | | Redo: policy.insuree(policy1,person2) | | | Fail: policy.insuree(policy1,person2) -| | | Redo: claim.claimant(claim4,V124) -| | | Fail: claim.claimant(claim4,V124) +| | | Redo: claim.claimant(claim4,V3603) +| | | Fail: claim.claimant(claim4,V3603) | | Fail: valid_insuree(claim4,policy1) | Fail: covered_under_policy(claim4,policy1,cardinal) -| Redo: policy.type(policy1,V53) -| Fail: policy.type(policy1,V53) -| Redo: claim.policy(X,V52) -| Fail: claim.policy(X,V52) +| Redo: policy.type(policy1,V3532) +| Fail: policy.type(policy1,V3532) +| Redo: claim.policy(X,V3531) +| Fail: claim.policy(X,V3531) Fail: covered(X) +====== Verbose Output for test: Test test_cases_routine_physical.hdf ====== +variable_expr: X +query_str: covered(X) +expected_result_list: [ 'claim3' ] +RESULTS: [ 'claim3' ] ===== TEST SUCCEEDED: Test test_cases_routine_physical.hdf===== ======= CARDINAL CARE TEST RESULTS SUMMARY ======= -1 out of 2 tests succeeded. +11 out of 11 tests succeeded. === FAILING TESTS === -Test test_cases_inpatient_care.hdf ============ END CARDINAL CARE TESTS ============ diff --git a/src/epilog.js b/src/epilog.js index 776ab12..74c8d9a 100644 --- a/src/epilog.js +++ b/src/epilog.js @@ -4889,4 +4889,5 @@ module.exports = { read, compfinds, grindem, + debugfinds }; diff --git a/src/test_running.js b/src/test_running.js index 2988933..ce58ba4 100644 --- a/src/test_running.js +++ b/src/test_running.js @@ -1,6 +1,7 @@ // Depends on epilog.js -const { definemorefacts, read, compfinds, readdata, grindem} = require('./epilog.js'); - +const { definemorefacts, read, compfinds, readdata, grindem, debugfinds} = require('./epilog.js'); +// import fs module +const fs = require('fs'); // Returns true if the query run on the dataset (induced by dataset_str) and the ruleset produces exactly the results in expected_result_list (ignoring order) // and false otherwise @@ -12,19 +13,24 @@ const { definemorefacts, read, compfinds, readdata, grindem} = require('./epilog // dataset_str (string): a string specifying the Epilog dataset that will be queried // ruleset (epilog ruleset): the ruleset that will be queried // verbose (boolean): if true, prints additional debug information to the console. If false, only prints whether the test failed or succeeded. - -function run_unit_test(test_name, variable_expr, query_str, expected_result_list, dataset_str, ruleset, verbose = false) { + // trace (boolean): if true, prints the trace of the query to the console + // Returns: true if the test succeeded, false otherwise + +function run_unit_test(test_name, variable_expr, query_str, expected_result_list, dataset_str, ruleset, verbose = false, trace = false) { let query = read(query_str); let dataset = definemorefacts([], readdata(dataset_str)); let results = compfinds(variable_expr, query, dataset, ruleset); - + if(trace) { + debugfinds(variable_expr, query, dataset, ruleset); + } let expected_result_set = new Set(expected_result_list); if (verbose > 1) { console.log("dataset_str:", dataset_str); console.log("dataset generated from dataset_str:", grindem(dataset)); console.log("ruleset:", ruleset); + console.log("generated ruleset:", grindem(ruleset)); } if (verbose > 0) { @@ -37,7 +43,6 @@ function run_unit_test(test_name, variable_expr, query_str, expected_result_list } let results_set = new Set(results); - //Check if the results contain the exactly same elements as the expected result set if (results_set.size != expected_result_set.size) { console.error("===== TEST FAILED: " + test_name + "===== ");