Fhir to Omop FhirPath rules example

[XcrigX]

As discussed during one of the meetings, here are the Fhir to Omop rules we (Accenture) have developed and are using in our (non-sql-on-fhir) custom converter.

I am providing the raw JSON rules our processor reads, and a CSV summary of them.

A few notes:

• Most of the mappings are pretty straightforward. A few create multiple records with references between them.
  For example, a Fhir Observation with components would create a header MEASURE record, and a MEASURE record for each component which references the header.

• The EOB mappings are are trying to separate line-level costs and header level costs and associate them back to a procedure or medication.
  The desired OMOP record structure from an EOB would look like:
  VISIT_OCCURRENCE
  -> CONDITION_OCCURRENCE
  -> COST (header level)
  -> PROCEDURE_OCCURRENCE
  ->-> COST (line level)
  -> DRUG_EXPOSURE
  ->-> COST (line level)

This structure may not be "universal", and could be brittle depending on the source data.
We used CarinBB as a guide, but for instance, to get the line level cost associated to a procedure assumes EOB.item.procedureSequence is present (and there is only 1). CarinBB does not mark EOB.item.procedureSequence as must support.

fhir2omopRules.csv

It seems I can't attach raw rules as a JSON/JSON5 file, so they are pasted inline:

[
  {
    "resourceType": "Patient",
    "rules": [
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          "childElementFhirPath": "Patient.address[0]",
          "childTable": "LOCATION",
          "keymapKey": "Patient.id",
          "rules": [
            {
              "fhirPath": "%context.city",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "CITY",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.state",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "STATE",
              "mappingHint": "STATE_ABBREVIATION",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.postalCode.replace('-', '')",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "ZIP",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 9
            },
            {
              "fhirPath": "%context.district",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "COUNTY",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 20
            },
            {
              "fhirPath": "%context.country",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "COUNTRY_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.line[0]",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "ADDRESS_1",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 50
            },
            {
              "fhirPath": "%context.line[1]",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "ADDRESS_2",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 50
            },
            {
              "fhirPath": "%context.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/geolocation').extension.where(url = 'latitude').value",
              "dataType": "float",
              "targetTable": "LOCATION",
              "targetAttribute": "LATITUDE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/geolocation').extension.where(url = 'longitude').value",
              "dataType": "float",
              "targetTable": "LOCATION",
              "targetAttribute": "LONGITUDE",
              "sourceExpressionType": "FHIR_PATH"
            }
          ]
        }
      },
      {
        "targetTable": "PERSON",
        "targetAttribute": "LOCATION_ID",
        "sourceExpressionType": "JOIN",
        "joinTable": "LOCATION",
        "joinKeyPath": "Patient.id"
      },
      {
        "fhirPath": "Patient.birthDate",
        "dataType": "Date",
        "targetTable": "PERSON",
        "targetAttribute": "YEAR_OF_BIRTH",
        "mappingHint": "DATEFUNC_YEAR",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Patient.birthDate",
        "dataType": "Date",
        "targetTable": "PERSON",
        "targetAttribute": "MONTH_OF_BIRTH",
        "mappingHint": "DATEFUNC_MONTH",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Patient.birthDate",
        "dataType": "Date",
        "targetTable": "PERSON",
        "targetAttribute": "DAY_OF_BIRTH",
        "mappingHint": "DATEFUNC_DAY",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Patient.gender",
        "dataType": "String",
        "targetTable": "PERSON",
        "targetAttribute": "GENDER_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "implicitCodeSystem": "http://hl7.org/fhir/ValueSet/administrative-gender",
        "required": true
      },
      {
        "fhirPath": "Patient.extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race').extension.where(url = 'ombCategory').value",
        "dataType": "Coding",
        "targetTable": "PERSON",
        "targetAttribute": "RACE_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "defaultValue": 0
      },
      {
        "fhirPath": "Patient.extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity').extension.where(url = 'ombCategory').value",
        "dataType": "Coding",
        "targetTable": "PERSON",
        "targetAttribute": "ETHNICITY_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "defaultValue": 0
      }
    ]
  },
  {
    "resourceType": "Condition",
    "rules": [
      {
        "fhirPath": "Condition.code",
        "dataType": "CodeableConcept",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "preferredCodeSystem": "http://snomed.info/sct",
        "sourceExpressionType": "FHIR_PATH",
        "required": true,
        "defaultValue": 0
      },
      {
        //"fhirPath": "Condition.code.coding[0].system + '|' + Condition.code.coding[0].code",
        "fhirPath": "Condition.code.coding[0].code",
        "dataType": "String",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Condition.abatement",
        "dataType": "DateTime",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_END_DATE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Condition.abatement",
        "dataType": "DateTime",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_END_DATETIME",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Condition.category[0].coding.where(system = 'http://terminology.hl7.org/CodeSystem/condition-category')",
        "dataType": "Coding",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_TYPE_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "defaultValue": 0
      },
      {
        "fhirPath": "Condition.onset",
        "dataType": "DateTime",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_START_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Condition.onset",
        "dataType": "DateTime",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_START_DATETIME",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Condition.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Condition.encounter",
        "dataType": "Reference",
        "referenceTarget": "VISIT_OCCURENCE",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "VISIT_OCCURRENCE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "iif(Condition.clinicalStatus.coding[0].code in ('inactive' | 'remission' | 'resolved'), Condition.clinicalStatus.coding[0].code, {})",
        "dataType": "String",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "STOP_REASON",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "clinicalStatus.coding[0].code",
        "dataType": "String",
        "targetTable": "CONDITION_OCCURRENCE",
        "targetAttribute": "CONDITION_STATUS_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      }
    ]
  },
  {
    "resourceType": "Encounter",
    "preconditionFhirPath": "Encounter.status = 'finished'",
    "rules": [
      {
        "fhirPath": "Encounter.class",
        "dataType": "Coding",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "defaultValue": 0
      },
      {
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 0
      },
      {
        "fhirPath": "Encounter.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Encounter.period.start",
        "dataType": "DateTime",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_START_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Encounter.period.start",
        "dataType": "DateTime",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_START_DATETIME",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Encounter.period.end",
        "dataType": "DateTime",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_END_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Encounter.period.end",
        "dataType": "DateTime",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_END_DATETIME",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Encounter.participant.individual",
        "dataType": "Reference",
        "referenceTarget": "PROVIDER",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "PROVIDER_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Encounter.serviceProvider",
        "dataType": "Reference",
        "referenceTarget": "CARE_SITE",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "CARE_SITE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        //"fhirPath": "Encounter.class.system + '|' + Encounter.class.code", too long
        "fhirPath": "Encounter.class.code",
        "dataType": "String",
        "targetTable": "VISIT_OCCURRENCE",
        "targetAttribute": "VISIT_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      }
    ]
  },
  {
    "resourceType": "Observation",
    "preconditionFhirPath": "Observation.status in ('final' | 'amended' | 'corrected')",
    "rules": [
      {
        "targetTable": "MEASUREMENT",
        "targetAttribute": "MEASUREMENT_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 32817
      },
      {
        "fhirPath": "Observation.code",
        "dataType": "CodeableConcept",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "MEASUREMENT_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "sourceExpressionType": "FHIR_PATH",
        "required": true,
        "X-comment": "note remove the default if you want to fail for unknown mappings",
        "defaultValue": 0
      },
      {
        "fhirPath": "Observation.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Observation.encounter",
        "dataType": "Reference",
        "referenceTarget": "VISIT_OCCURRENCE",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "VISIT_OCCURRENCE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Observation.effective",
        "dataType": "DateTime",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "MEASUREMENT_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Observation.effective",
        "dataType": "DateTime",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "MEASUREMENT_DATETIME",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Observation.value.ofType(Quantity)",
        "dataType": "CodeableConcept",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "UNIT_CONCEPT_ID",
        "mappingHint": "QUANTITY",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Observation.value.ofType(Quantity).code",
        "dataType": "String",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "UNIT_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Observation.value.ofType(Quantity).value",
        "dataType": "Float",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "VALUE_AS_NUMBER",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Observation.value.ofType(Quantity).comparator",
        "dataType": "String",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "OPERATOR_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "implicitCodeSystem": "http://hl7.org/fhir/quantity-comparator"
      },
      {
        "fhirPath": "Observation.value.ofType(CodeableConcept)",
        "dataType": "CodeableConcept",
        "targetTable": "MEASUREMENT",
        "targetAttribute": "VALUE_AS_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        //this child element comes last instead of first since we need the key of the Observation parent record
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          "childElementFhirPath": "Observation.component.where(code.coding[0].code.exists())",
          "childTable": "MEASUREMENT",
          "keymapKey": "%resource.id + '-' + code.coding[0].code",
          "rules": [
            {
              "fhirPath": "%resource.id",
              "dataType": "String",
              "referenceTarget": "MEASUREMENT",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "MEASUREMENT_EVENT_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "targetTable": "MEASUREMENT",
              "targetAttribute": "MEASUREMENT_TYPE_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 32817
            },
            {
              "fhirPath": "%context.code",
              "dataType": "CodeableConcept",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "MEASUREMENT_CONCEPT_ID",
              "mappingHint": "CONCEPT_LOOKUP",
              "sourceExpressionType": "FHIR_PATH",
              "required": true,
              "X-comment": "note remove the default if you want to fail for unknown mappings",
              "defaultValue": 0
            },
            {
              "fhirPath": "%resource.subject",
              "dataType": "Reference",
              "referenceTarget": "PERSON",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "PERSON_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%resource.encounter",
              "dataType": "Reference",
              "referenceTarget": "VISIT_OCCURRENCE",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "VISIT_OCCURRENCE_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%resource.effective",
              "dataType": "DateTime",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "MEASUREMENT_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%resource.effective",
              "dataType": "DateTime",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "MEASUREMENT_DATETIME",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.value.ofType(Quantity)",
              "dataType": "CodeableConcept",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "UNIT_CONCEPT_ID",
              "mappingHint": "QUANTITY",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.value.ofType(Quantity).code",
              "dataType": "String",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "UNIT_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.value.ofType(Quantity).value",
              "dataType": "Float",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "VALUE_AS_NUMBER",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.value.ofType(CodeableConcept)",
              "dataType": "CodeableConcept",
              "targetTable": "MEASUREMENT",
              "targetAttribute": "VALUE_AS_CONCEPT_ID",
              "mappingHint": "CONCEPT_LOOKUP",
              "sourceExpressionType": "FHIR_PATH"
            }
          ]
        }
      }
    ]
  },
  {
    "resourceType": "Procedure",
    "preconditionFhirPath": "Procedure.status = 'completed'",
    "rules": [
      {
        "fhirPath": "Procedure.code",
        "dataType": "CodeableConcept",
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "PROCEDURE_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "preferredCodeSystem": "http://snomed.info/sct",
        "sourceExpressionType": "FHIR_PATH",
        "required": true,
        "defaultValue": 0
      },
      {
        //"fhirPath": "Procedure.code.coding[0].system + '|' + Procedure.code.coding[0].code",
        "fhirPath": "Procedure.code.coding[0].code",
        "dataType": "String",
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "PROCEDURE_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Procedure.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Procedure.encounter",
        "dataType": "Reference",
        "referenceTarget": "VISIT_OCCURRENCE",
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "VISIT_OCCURRENCE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "iif(Procedure.performed.start.exists(), Procedure.performed.start, Procedure.performed)",
        "dataType": "DateTime",
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "PROCEDURE_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "iif(Procedure.performed.end.exists(), Procedure.performed.end, Procedure.performed)",
        "dataType": "DateTime",
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "PROCEDURE_END_DATE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "targetTable": "PROCEDURE_OCCURRENCE",
        "targetAttribute": "PROCEDURE_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 32817
      }
    ]
  },
  {
    "resourceType": "MedicationRequest",
    "preconditionFhirPath": "(MedicationRequest.status = 'active' or MedicationRequest.status = 'completed') and MedicationRequest.medication.ofType(CodeableConcept).exists()",
    "rules": [
      {
        "fhirPath": "MedicationRequest.medication",
        "dataType": "CodeableConcept",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "sourceExpressionType": "FHIR_PATH",
        "required": true,
        "defaultValue": 0
      },
      {
        "fhirPath": "MedicationRequest.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "MedicationRequest.encounter",
        "dataType": "Reference",
        "referenceTarget": "VISIT_OCCURRENCE",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "VISIT_OCCURRENCE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "iif(MedicationRequest.dispenseRequest.validityPeriod.start.exists(), MedicationRequest.dispenseRequest.validityPeriod.start, MedicationRequest.authoredOn)",
        "dataType": "DateTime",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_EXPOSURE_START_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "iif(MedicationRequest.dispenseRequest.validityPeriod.end.exists(), MedicationRequest.dispenseRequest.validityPeriod.end, iif(MedicationRequest.authoredOn.exists(), MedicationRequest.authoredOn,  '2099-12-31'))",
        "dataType": "DateTime",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_EXPOSURE_END_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 32839
      },
      {
        "fhirPath": "MedicationRequest.requester",
        "dataType": "Reference",
        "referenceTarget": "PROVIDER",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "PROVIDER_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        //"fhirPath": "MedicationRequest.medication.coding[0].system + '|' + MedicationRequest.medication.coding[0].code",
        "fhirPath": "MedicationRequest.medication.coding[0].code",
        "dataType": "String",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      }
    ]
  },
  {
    "resourceType": "MedicationDispense",
    "preconditionFhirPath": "MedicationDispense.status = 'completed' and MedicationDispense.medication.ofType(CodeableConcept).exists()",
    "rules": [
      {
        "fhirPath": "MedicationDispense.medication",
        "dataType": "CodeableConcept",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "sourceExpressionType": "FHIR_PATH",
        "required": true,
        "defaultValue": 0
      },
      {
        "fhirPath": "MedicationDispense.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "MedicationDispense.context",
        "dataType": "Reference",
        "referenceTarget": "VISIT_OCCURRENCE",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "VISIT_OCCURRENCE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "iif(MedicationDispense.whenHandedOver.exists(), MedicationDispense.whenHandedOver, MedicationDispense.whenPrepared)",
        "dataType": "DateTime",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_EXPOSURE_START_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "iif(MedicationDispense.whenHandedOver.exists(),MedicationDispense.whenHandedOver + MedicationDispense.daysSupply,MedicationDispense.whenPrepared+ MedicationDispense.daysSupply)",
        "dataType": "DateTime",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_EXPOSURE_END_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 32825
      },
      {
        "fhirPath": "MedicationDispense.dosageInstruction[0].text",
        "dataType": "String",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "SIG",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "MedicationDispense.daysSupply.value",
        "dataType": "Integer",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DAYS_SUPPLY",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "MedicationDispense.quantity.value",
        "dataType": "Float",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "QUANTITY",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "MedicationDispense.performer.actor",
        "dataType": "Reference",
        "referenceTarget": "PROVIDER",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "PROVIDER_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        //"fhirPath": "MedicationRequest.medication.coding[0].system + '|' + MedicationRequest.medication.coding[0].code",
        "fhirPath": "MedicationDispense.medication.coding[0].code",
        "dataType": "String",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      }
    ]
  },
  {
    "resourceType": "MedicationAdministration",
    "preconditionFhirPath": "MedicationAdministration.status = 'completed' and MedicationAdministration.medication.ofType(CodeableConcept).exists()",
    "rules": [
      {
        "fhirPath": "MedicationAdministration.medication",
        "dataType": "CodeableConcept",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "sourceExpressionType": "FHIR_PATH",
        "required": true,
        "defaultValue": 0
      },
      {
        "fhirPath": "MedicationAdministration.subject",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "MedicationAdministration.context",
        "dataType": "Reference",
        "referenceTarget": "VISIT_OCCURRENCE",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "VISIT_OCCURRENCE_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "iif(MedicationAdministration.effective.start.exists(), MedicationAdministration.effective.start, MedicationAdministration.effective)",
        "dataType": "DateTime",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_EXPOSURE_START_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "iif(MedicationAdministration.effective.end.exists(), MedicationAdministration.effective.end, MedicationAdministration.effective)",
        "dataType": "DateTime",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_EXPOSURE_END_DATE",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 32818
      },
      {
        "fhirPath": "MedicationAdministration.dosage.text",
        "dataType": "String",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "SIG",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "MedicationAdministration.dosage.dose.value",
        "dataType": "Float",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "QUANTITY",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "MedicationAdministration.performer.actor",
        "dataType": "Reference",
        "referenceTarget": "PROVIDER",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "PROVIDER_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        //"fhirPath": "MedicationRequest.medication.coding[0].system + '|' + MedicationRequest.medication.coding[0].code",
        "fhirPath": "MedicationAdministration.medication.coding[0].code",
        "dataType": "String",
        "targetTable": "DRUG_EXPOSURE",
        "targetAttribute": "DRUG_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      }
    ]
  },
  {
    "resourceType": "Organization",
    //"preconditionFhirPath": "Organization.active = 'true'",
    "rules": [
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          "childElementFhirPath": "Organization.address[0]",
          "childTable": "LOCATION",
          "keymapKey": "Organization.id",
          "rules": [
            {
              "fhirPath": "%context.city",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "CITY",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.state",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "STATE",
              "mappingHint": "STATE_ABBREVIATION",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.postalCode.replace('-', '')",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "ZIP",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 9
            },
            {
              "fhirPath": "%context.district",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "COUNTY",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 20
            },
            {
              "fhirPath": "%context.country",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "COUNTRY_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.line[0]",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "ADDRESS_1",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 50
            },
            {
              "fhirPath": "%context.line[1]",
              "dataType": "String",
              "targetTable": "LOCATION",
              "targetAttribute": "ADDRESS_2",
              "sourceExpressionType": "FHIR_PATH",
              "truncateLength": 50
            },
            {
              "fhirPath": "%context.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/geolocation').extension.where(url = 'latitude').value",
              "dataType": "float",
              "targetTable": "LOCATION",
              "targetAttribute": "LATITUDE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/geolocation').extension.where(url = 'longitude').value",
              "dataType": "float",
              "targetTable": "LOCATION",
              "targetAttribute": "LONGITUDE",
              "sourceExpressionType": "FHIR_PATH"
            }
          ]
        }
      },
      {
        "targetTable": "CARE_SITE",
        "targetAttribute": "LOCATION_ID",
        "sourceExpressionType": "JOIN",
        "joinTable": "LOCATION",
        "joinKeyPath": "Organization.id"
      },
      {
        "fhirPath": "Organization.name",
        "dataType": "String",
        "targetTable": "CARE_SITE",
        "targetAttribute": "CARE_SITE_NAME",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Organization.type[0].coding.where(system = 'http://terminology.hl7.org/CodeSystem/organization-type')",
        "dataType": "Coding",
        "targetTable": "CARE_SITE",
        "targetAttribute": "PLACE_OF_SERVICE_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "defaultValue": 0
      }
    ]
  },
  {
    "resourceType": "Practitioner",
    "rules": [
      {
        "fhirPath": "Practitioner.identifier.where(system = 'http://hl7.org/fhir/sid/us-npi').value",
        "dataType": "String",
        "targetTable": "PROVIDER",
        "targetAttribute": "NPI",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Practitioner.gender",
        "dataType": "String",
        "targetTable": "PROVIDER",
        "targetAttribute": "GENDER_CONCEPT_ID",
        "mappingHint": "CONCEPT_MAP",
        "sourceExpressionType": "FHIR_PATH",
        "implicitCodeSystem": "http://hl7.org/fhir/ValueSet/administrative-gender"
      },
      {
        "fhirPath": "iif(Practitioner.name[0].text.exists(), Practitioner.name[0].text,  Practitioner.name[0].family + ', ' + Practitioner.name[0].given[0])",
        "dataType": "String",
        "targetTable": "PROVIDER",
        "targetAttribute": "PROVIDER_NAME",
        "sourceExpressionType": "FHIR_PATH"
      }
      /*,{
         
         "fhirPath": "'Practitioner/' + Practitioner.id",
         "dataType": "String",
         "targetTable": "PROVIDER",
         "targetAttribute": "PROVIDER_SOURCE_VALUE",
         "sourceExpressionType": "FHIR_PATH",
         "tags": [
           "SOURCE_KEY"
         ]
       }*/
    ]
  },
  {
    "resourceType": "ExplanationOfBenefit",
    "rules": [
      //parent VISIT_OCCURRENCE
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          "childElementFhirPath": "ExplanationOfBenefit",
          "childTable": "VISIT_OCCURRENCE",
          "keymapKey": "%context.id",
          "rules": [
            {
              "fhirPath": "%context.patient",
              "dataType": "Reference",
              "referenceTarget": "PERSON",
              "targetTable": "VISIT_OCCURRENCE",
              "targetAttribute": "PERSON_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "",
              "dataType": "String",
              "targetTable": "VISIT_OCCURRENCE",
              "targetAttribute": "VISIT_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 0
            },
            {
              "fhirPath": "%context.billablePeriod.start",
              "dataType": "DateTime",
              "targetTable": "VISIT_OCCURRENCE",
              "targetAttribute": "VISIT_START_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%context.billablePeriod.end",
              "dataType": "DateTime",
              "targetTable": "VISIT_OCCURRENCE",
              "targetAttribute": "VISIT_END_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%context.provider",
              "dataType": "Reference",
              "referenceTarget": "PROVIDER",
              "targetTable": "VISIT_OCCURRENCE",
              "targetAttribute": "PROVIDER_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "",
              "dataType": "String",
              "targetTable": "VISIT_OCCURRENCE",
              "targetAttribute": "VISIT_TYPE_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 0
            }
          ]
        }
      },
      //procedures
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          //dont process if it's a reference to a procedure. CarinBB requires a CodeableConcept
          "childElementFhirPath": "ExplanationOfBenefit.procedure.where(procedure is CodeableConcept)",
          "childTable": "PROCEDURE_OCCURRENCE",
          "keymapKey": "%resource.id + '-' + %context.sequence.toString()",
          "rules": [
            {
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "VISIT_OCCURRENCE_ID",
              "sourceExpressionType": "JOIN",
              "joinTable": "VISIT_OCCURRENCE",
              "joinKeyPath": "%resource.id"
            },
            {
              "fhirPath": "%context.procedure.ofType(CodeableConcept)",
              "dataType": "CodeableConcept",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PROCEDURE_CONCEPT_ID",
              "mappingHint": "CONCEPT_LOOKUP",
              "preferredCodeSystem": "http://snomed.info/sct",
              "sourceExpressionType": "FHIR_PATH",
              "required": true,
              "defaultValue": 0
            },
            {
              "fhirPath": "%context.procedure.ofType(CodeableConcept).coding[0].code",
              "dataType": "String",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PROCEDURE_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%resource.patient",
              "dataType": "Reference",
              "referenceTarget": "PERSON",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PERSON_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%context.date",
              "dataType": "DateTime",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PROCEDURE_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%context.date",
              "dataType": "DateTime",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PROCEDURE_END_DATE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PROCEDURE_TYPE_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 32810
              //32810 = Claim
            },
            {
              "fhirPath": "%resource.item.where(procedureSequence = %context.sequence)[0].modifier",
              "dataType": "CodeableConcept",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "MODIFIER_CONCEPT_ID",
              "sourceExpressionType": "FHIR_PATH",
              "mappingHint": "CONCEPT_LOOKUP"
            },
            {
              "fhirPath": "%resource.provider",
              "dataType": "Reference",
              "referenceTarget": "PROVIDER",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "PROVIDER_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%resource.item.where(procedureSequence = %context.sequence)[0].quantity.value",
              "dataType": "Integer",
              "targetTable": "PROCEDURE_OCCURRENCE",
              "targetAttribute": "QUANTITY",
              "sourceExpressionType": "FHIR_PATH",
              "defaultValue": 1
            }
          ]
        }
      },
      // Prescriptions - Drugs - Medications
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          "childElementFhirPath": "ExplanationOfBenefit.item.where(productOrService.coding.system = 'http://hl7.org/fhir/sid/ndc')",
          "childTable": "DRUG_EXPOSURE",
          "keymapKey": "%resource.id + '-' + %context.sequence.toString()",
          "rules": [
            {
              "fhirPath": "%context.productOrService",
              "dataType": "CodeableConcept",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "DRUG_CONCEPT_ID",
              "mappingHint": "CONCEPT_LOOKUP",
              "preferredCodeSystem": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "sourceExpressionType": "FHIR_PATH",
              "required": true,
              "defaultValue": 0
            },
            {
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "DRUG_TYPE_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 32810
              //32810 = Claim
            },
            {
              "fhirPath": "%resource.patient",
              "dataType": "Reference",
              "referenceTarget": "PERSON",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "PERSON_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%resource.billablePeriod.start",
              "dataType": "DateTime",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "DRUG_EXPOSURE_START_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%resource.billablePeriod.end",
              "dataType": "DateTime",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "DRUG_EXPOSURE_END_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%resource.supportingInfo.where(category.coding.system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType' and category.coding.code = 'refillnum').value.value",
              "dataType": "Integer",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "REFILLS",
              "sourceExpressionType": "FHIR_PATH"
              //"required": true
            },
            {
              "fhirPath": "%context.quantity.value",
              "dataType": "Float",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "QUANTITY",
              "sourceExpressionType": "FHIR_PATH"
              //"required": true
            },
            {
              "fhirPath": "%resource.supportingInfo.where(category.coding.system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType' and category.coding.code = 'dayssupply').value.value",
              "dataType": "Integer",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "DAYS_SUPPLY",
              "sourceExpressionType": "FHIR_PATH"
              //"required": true
            },
            {
              "fhirPath": "%resource.provider",
              "dataType": "Reference",
              "referenceTarget": "PROVIDER",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "PROVIDER_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "VISIT_OCCURRENCE_ID",
              "sourceExpressionType": "JOIN",
              "joinTable": "VISIT_OCCURRENCE",
              "joinKeyPath": "%resource.id"
            },
            {
              "fhirPath": "%context.productOrService.coding[0].code",
              "dataType": "String",
              "targetTable": "DRUG_EXPOSURE",
              "targetAttribute": "DRUG_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            }
          ]
        }
      },
      //line level cost records
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          "childElementFhirPath": "ExplanationOfBenefit.item",
          "childTable": "COST",
          "keymapKey": "%resource.id + '-' + %context.sequence.toString()",
          "rules": [
            //if we have a procedureSequence, associate the cost with a procedure
            {
              "preconditionFhirPath": "%context.procedureSequence.exists()",
              "fhirPath": "%resource.id + '-' + %context.procedureSequence[0].toString()",
              "dataType": "String",
              "targetTable": "COST",
              "targetAttribute": "COST_EVENT_ID",
              "mappingHint": "FHIR2OMOPID",
              "referenceTarget": "PROCEDURE_OCCURRENCE",
              "sourceExpressionType": "FHIR_PATH",
              "required": false
            },
            //if we have an NDC code, associate to the drug exposure
            {
              "preconditionFhirPath": "%context.where(productOrService.coding.system = 'http://hl7.org/fhir/sid/ndc').exists()",
              "fhirPath": "%resource.id + '-' + %context.sequence.toString()",
              "dataType": "String",
              "targetTable": "COST",
              "targetAttribute": "COST_EVENT_ID",
              "mappingHint": "FHIR2OMOPID",
              "referenceTarget": "DRUG_EXPOSURE",
              "sourceExpressionType": "FHIR_PATH",
              "required": false
            },
            //otherwise, associate to the visit
            {
              "preconditionFhirPath": "%context.procedureSequence.exists().not() and %context.where(productOrService.coding.system = 'http://hl7.org/fhir/sid/ndc').exists().not()",
              "targetTable": "COST",
              "targetAttribute": "COST_EVENT_ID",
              "sourceExpressionType": "JOIN",
              "joinTable": "VISIT_OCCURRENCE",
              "joinKeyPath": "%resource.id"
            },
            {
              //depending on whether it's a drug, procedure, or other.. tag the domain id

              "fhirPath": "iif( %context.where(productOrService.coding.system = 'http://hl7.org/fhir/sid/ndc').exists() , 'Drug', iif(%context.procedureSequence.exists(), 'Procedure', 'Visit'))",
              "dataType": "String",
              "targetTable": "COST",
              "targetAttribute": "COST_DOMAIN_ID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "",
              "dataType": "String",
              "targetTable": "COST",
              "targetAttribute": "COST_TYPE_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 0
            },
            {
              "fhirPath": "",
              "dataType": "String",
              "targetTable": "COST",
              "targetAttribute": "CURRENCY_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "X-comment": "code for USD",
              "defaultValue": 44818668
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'submitted').amount.value",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "TOTAL_CHARGE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "TOTAL_COST",
              "mappingHint": "NOOP",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.exists((system = 'http://terminology.hl7.org/CodeSystem/adjudication' and (code = 'copay' )) or (system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and ( code = 'coinsurance' or code = 'priorpayerpaid' or code = 'paidtopatient' or code = 'paidtoprovider' or code = 'drugcost')))).amount.value.aggregate($this + $total, 0)",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "TOTAL_PAID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.exists(system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and (code = 'priorpayerpaid' or code = 'paidtopatient' or code =  'paidtoprovider'))).amount.value.aggregate($this + $total, 0)",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "PAID_BY_PAYER",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              //"fhirPath": "ExplanationOfBenefit.total.where(category.coding.exists((system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and ( code =  'paidbypatient' )))).amount.value.aggregate($this + $total, 0)",
              "fhirPath": "%context.adjudication.where(category.coding.exists((system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and ( code =  'paidbypatient' )))).amount.value.aggregate($this + $total, 0)",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "PAID_BY_PATIENT",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'copay').amount.value",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "PAID_PATIENT_COPAY",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and category.coding.code = 'coinsurance').amount.value",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "PAID_PATIENT_COINSURANCE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'deductible').amount.value",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "PAID_PATIENT_DEDUCTIBLE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.adjudication.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'benefit').amount.value",
              "dataType": "Float",
              "targetTable": "COST",
              "targetAttribute": "AMOUNT_ALLOWED",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.revenue",
              "dataType": "CodeableConcept",
              "targetTable": "COST",
              "targetAttribute": "REVENUE_CODE_CONCEPT_ID",
              "mappingHint": "CONCEPT_LOOKUP",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.revenue.coding[0].code",
              "dataType": "String",
              "targetTable": "COST",
              "targetAttribute": "REVENUE_CODE_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            }
          ]
        }
      },
      //conditions / diagnoses
      {
        "sourceExpressionType": "CHILD_ELEMENT",
        "childElement": {
          //dont process if any of the diagnoses are references rather than codeableconcepts
          "childElementFhirPath": "ExplanationOfBenefit.diagnosis.where(diagnosis is CodeableConcept)",
          "childTable": "CONDITION_OCCURRENCE",
          "keymapKey": "%resource.id + '-' + %context.sequence.toString()",
          "rules": [
            {
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "VISIT_OCCURRENCE_ID",
              "sourceExpressionType": "JOIN",
              "joinTable": "VISIT_OCCURRENCE",
              "joinKeyPath": "%resource.id"
            },
            {
              "fhirPath": "%resource.patient",
              "dataType": "Reference",
              "referenceTarget": "PERSON",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "PERSON_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%context.diagnosis.ofType(CodeableConcept)",
              "dataType": "CodeableConcept",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "CONDITION_CONCEPT_ID",
              "mappingHint": "CONCEPT_LOOKUP",
              "preferredCodeSystem": "http://snomed.info/sct",
              "sourceExpressionType": "FHIR_PATH",
              "required": true,
              "defaultValue": 0
            },
            {
              "fhirPath": "%context.diagnosis.ofType(CodeableConcept).coding[0].code",
              "dataType": "String",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "CONDITION_SOURCE_VALUE",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%resource.billablePeriod.start",
              "dataType": "DateTime",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "CONDITION_START_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "fhirPath": "%resource.billablePeriod.end",
              "dataType": "DateTime",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "CONDITION_END_DATE",
              "sourceExpressionType": "FHIR_PATH",
              "required": true
            },
            {
              "dataType": "String",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "CONDITION_TYPE_CONCEPT_ID",
              "sourceExpressionType": "STATIC",
              "defaultValue": 0
            },
            {
              "fhirPath": "%resource.provider",
              "dataType": "Reference",
              "referenceTarget": "PROVIDER",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "PROVIDER_ID",
              "mappingHint": "FHIR2OMOPID",
              "sourceExpressionType": "FHIR_PATH"
            },
            {
              "fhirPath": "%context.type.coding[0]",
              "dataType": "Coding",
              "targetTable": "CONDITION_OCCURRENCE",
              "targetAttribute": "CONDITION_STATUS_CONCEPT_ID",
              "mappingHint": "CONCEPT_MAP",
              "sourceExpressionType": "FHIR_PATH"
            }

            /*{
              
              "targetTable": "COST",
              "targetAttribute": "COST_EVENT_ID",
              "sourceExpressionType": "JOIN",
              "joinTable": "CONDITION_OCCURRENCE"
            },*/
          ]
        }
      },
      {
        "targetTable": "COST",
        "targetAttribute": "COST_EVENT_ID",
        "sourceExpressionType": "JOIN",
        "joinTable": "VISIT_OCCURRENCE",
        "joinKeyPath": "%resource.id"
      },
      {
        "fhirPath": "",
        "dataType": "String",
        "targetTable": "COST",
        "targetAttribute": "COST_DOMAIN_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": "Cost"
      },
      {
        "fhirPath": "",
        "dataType": "String",
        "targetTable": "COST",
        "targetAttribute": "COST_TYPE_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "defaultValue": 0
      },
      {
        "fhirPath": "",
        "dataType": "String",
        "targetTable": "COST",
        "targetAttribute": "CURRENCY_CONCEPT_ID",
        "sourceExpressionType": "STATIC",
        "X-comment": "code for USD",
        "defaultValue": 44818668
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'submitted').amount.value",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "TOTAL_CHARGE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "TOTAL_COST",
        "mappingHint": "NOOP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.exists((system = 'http://terminology.hl7.org/CodeSystem/adjudication' and (code = 'copay' )) or (system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and ( code = 'coinsurance' or code = 'priorpayerpaid' or code = 'paidtopatient' or code = 'paidtoprovider' or code = 'drugcost')))).amount.value.aggregate($this + $total, 0)",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "TOTAL_PAID",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.exists(system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and (code = 'priorpayerpaid' or code = 'paidtopatient' or code =  'paidtoprovider'))).amount.value.aggregate($this + $total, 0)",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_BY_PAYER",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        //"fhirPath": "ExplanationOfBenefit.total.where(category.coding.exists((system = 'http://terminology.hl7.org/CodeSystem/adjudication' and (code = 'copay' )) or (system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and ( code =  'paidbypatient' or code = 'coinsurance')))).amount.value.aggregate($this + $total, 0)",
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.exists((system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and ( code =  'paidbypatient' )))).amount.value.aggregate($this + $total, 0)",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_BY_PATIENT",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'copay').amount.value",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_PATIENT_COPAY",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and category.coding.code = 'coinsurance').amount.value",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_PATIENT_COINSURANCE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'deductible').amount.value",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_PATIENT_DEDUCTIBLE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_BY_PRIMARY",
        "mappingHint": "NOOP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_INGREDIENT_COST",
        "mappingHint": "NOOP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "PAID_DISPENSING_FEE",
        "mappingHint": "NOOP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "",
        "dataType": "Integer",
        "targetTable": "COST",
        "targetAttribute": "PAYER_PLAN_PERIOD_ID",
        "mappingHint": "NOOP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.total.where(category.coding.system = 'http://terminology.hl7.org/CodeSystem/adjudication' and category.coding.code = 'benefit').amount.value",
        "dataType": "Float",
        "targetTable": "COST",
        "targetAttribute": "AMOUNT_ALLOWED",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "ExplanationOfBenefit.supportingInfo.code.where(coding.system='https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software')",
        "dataType": "CodeableConcept",
        "targetTable": "COST",
        "targetAttribute": "DRG_CONCEPT_ID",
        "mappingHint": "CONCEPT_LOOKUP",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "",
        "dataType": "String",
        "targetTable": "COST",
        "targetAttribute": "DRG_SOURCE_VALUE",
        "mappingHint": "NOOP",
        "sourceExpressionType": "FHIR_PATH"
      }
    ]
  },
  {
    "resourceType": "Coverage",
    "rules": [
      {
        "fhirPath": "Coverage.beneficiary",
        "dataType": "Reference",
        "referenceTarget": "PERSON",
        "targetTable": "PAYER_PLAN_PERIOD",
        "targetAttribute": "PERSON_ID",
        "mappingHint": "FHIR2OMOPID",
        "sourceExpressionType": "FHIR_PATH",
        "required": true
      },
      {
        "fhirPath": "Coverage.period.start",
        "dataType": "DateTime",
        "targetTable": "PAYER_PLAN_PERIOD",
        "targetAttribute": "PAYER_PLAN_PERIOD_START_DATE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "iif( Coverage.period.end.exists(), Coverage.period.end, (Coverage.period.start + 1 years))",
        "dataType": "DateTime",
        "targetTable": "PAYER_PLAN_PERIOD",
        "targetAttribute": "PAYER_PLAN_PERIOD_END_DATE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Coverage.payor.ofType(Reference).reference",
        "dataType": "String",
        "targetTable": "PAYER_PLAN_PERIOD",
        "targetAttribute": "PAYER_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Coverage.class.where(type.coding.system = 'http://terminology.hl7.org/CodeSystem/coverage-class' and type.coding.code = 'group').value + '-' + Coverage.class.where(type.coding.system = 'http://terminology.hl7.org/CodeSystem/coverage-class' and type.coding.code = 'plan').value",
        "dataType": "String",
        "targetTable": "PAYER_PLAN_PERIOD",
        "targetAttribute": "PLAN_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      },
      {
        "fhirPath": "Coverage.type.coding[0].code",
        "dataType": "String",
        "targetTable": "PAYER_PLAN_PERIOD",
        "targetAttribute": "SPONSOR_SOURCE_VALUE",
        "sourceExpressionType": "FHIR_PATH"
      }
      //PAYER_CONCEPT_ID
      //PAYER_SOURCE_CONCEPT_ID
      //PLAN_CONCEPT_ID
      //PLAN_SOURCE_CONCEPT_ID
      //SPONSOR_CONCEPT_ID
      //SPONSOR_SOURCE_CONCEPT_ID
      //FAMILY_SOURCE_VALUE
      //STOP_REASON_CONCEPT_ID
      //STOP_REASON_SOURCE_VALUE
      //STOP_REASON_SOURCE_CONCEPT_ID,
    ]
  }
]