SQL-177: MedicareQueryProvider.FindMedicareHistoryMatch

This statement is a read operation invoked through ORM (NHibernate LINQ). Executed by MedicareQueryProvider.FindMedicareHistoryMatch.

Classification

Field	Value
SQL ID	SQL-177
Operation type	Read
Execution method	ORM (NHibernate LINQ)
Database	Oracle*
Schema	[unqualified]**
Command type	N/A (ORM-generated)
Business object	MedicareQueryProvider
Criteria property	N/A — ORM
Lifecycle method	FindMedicareHistoryMatch

Parameters

Parameter	Direction	Type	Max length	Description
medicareBeneficiary	Input	MedicareBeneficiaryQuery	N/A	Method argument of MedicareQueryProvider.FindMedicareHistoryMatch bound into the ORM expression; NHibernate generates the bind variable at runtime

Tables

Table	Access	Columns used
MEDICARE_QUERY_HISTORY	SELECT	MEDICARE_QUERY_HISTORY_SEQ_NUM, UPDATE_NUM, CLAIM_PERSON_ID, FIRST_SUBMISSION_DATE, LAST_SUBMISSION_DATE, TAX_ID, LAST_NAME, FIRST_INITIAL, GENDER_CODE, BIRTH_DATE, PRIMARY_TAX_ID_FLAG, MEDICARE_BENEFICIARY_FLAG, RESPONSE_MEDICARE_CLAIM_NUMBER, RESPONSE_TAX_ID, RESPONSE_LAST_NAME, RESPONSE_FIRST_INITIAL, RESPONSE_GENDER_CODE, RESPONSE_BIRTH_DATE, UPDATE_USER, UPDATE_DATE

LINQ statement

Source: Data/SAIF.Data/Queries/Claims/MedicareQueryProvider.cs:30-44. The repository/queryable is initialised at Data/SAIF.Data/Queries/Claims/MedicareQueryProvider.cs:19.

// Data/SAIF.Data/Queries/Claims/MedicareQueryProvider.cs:19
medicareHistoryRepository = factory.GetRepository<MedicareQueryHistory>().Query();

// Data/SAIF.Data/Queries/Claims/MedicareQueryProvider.cs:30-44
public MedicareQueryHistory FindMedicareHistoryMatch(MedicareBeneficiaryQuery medicareBeneficiary)
{
        return medicareHistoryRepository.SingleOrDefault(x => x.PersonId == medicareBeneficiary.PersonId
          && x.TaxId == medicareBeneficiary.TaxId
          && x.LastName == medicareBeneficiary.LastName
          && x.FirstInitial == medicareBeneficiary.FirstInitial
          && x.GenderCode == medicareBeneficiary.GenderCode
          && x.BirthDate == medicareBeneficiary.BirthDate
          && x.IsPrimaryTaxId == medicareBeneficiary.IsPrimaryTaxId
          && x.IsMedicareBeneficiary == medicareBeneficiary.IsMedicareBeneficiary
          && x.ResponseMedicareClaimNumber == medicareBeneficiary.ResponseMedicareClaimNumber
          && x.ResponseTaxId == medicareBeneficiary.ResponseTaxId
          && x.ResponseLastName == medicareBeneficiary.ResponseLastName
          && x.ResponseFirstInitial == medicareBeneficiary.ResponseFirstInitial
          && x.ResponseGenderCode == medicareBeneficiary.ResponseGenderCode
          && x.ResponseBirthDate == medicareBeneficiary.ResponseBirthDate
          );
}

Sample SQL

Inferred SQL: This SQL was inferred from the LINQ statement above and the NHibernate mappings. It is not concrete SQL from source code; NHibernate generates the executed statement at runtime, so aliases, column order, join syntax, and bind-parameter names may differ.

-- Inferred from LINQ (NHibernate mapping translation); not concrete SQL
SELECT
  MQH.MEDICARE_QUERY_HISTORY_SEQ_NUM,
  MQH.UPDATE_NUM,
  MQH.CLAIM_PERSON_ID,
  MQH.FIRST_SUBMISSION_DATE,
  MQH.LAST_SUBMISSION_DATE,
  MQH.TAX_ID,
  MQH.LAST_NAME,
  MQH.FIRST_INITIAL,
  MQH.GENDER_CODE,
  MQH.BIRTH_DATE,
  MQH.PRIMARY_TAX_ID_FLAG,
  MQH.MEDICARE_BENEFICIARY_FLAG,
  MQH.RESPONSE_MEDICARE_CLAIM_NUMBER,
  MQH.RESPONSE_TAX_ID,
  MQH.RESPONSE_LAST_NAME,
  MQH.RESPONSE_FIRST_INITIAL,
  MQH.RESPONSE_GENDER_CODE,
  MQH.RESPONSE_BIRTH_DATE,
  MQH.UPDATE_USER,
  MQH.UPDATE_DATE
FROM MEDICARE_QUERY_HISTORY MQH
WHERE MQH.CLAIM_PERSON_ID = :PersonId
  AND MQH.TAX_ID = :TaxId
  AND MQH.LAST_NAME = :LastName
  AND MQH.FIRST_INITIAL = :FirstInitial
  AND MQH.GENDER_CODE = :GenderCode
  AND MQH.BIRTH_DATE = :BirthDate
  AND MQH.PRIMARY_TAX_ID_FLAG = :IsPrimaryTaxId
  AND MQH.MEDICARE_BENEFICIARY_FLAG = :IsMedicareBeneficiary
  AND MQH.RESPONSE_MEDICARE_CLAIM_NUMBER = :ResponseMedicareClaimNumber
  AND MQH.RESPONSE_TAX_ID = :ResponseTaxId
  AND MQH.RESPONSE_LAST_NAME = :ResponseLastName
  AND MQH.RESPONSE_FIRST_INITIAL = :ResponseFirstInitial
  AND MQH.RESPONSE_GENDER_CODE = :ResponseGenderCode
  AND MQH.RESPONSE_BIRTH_DATE = :ResponseBirthDate
-- SingleOrDefault: NHibernate expects at most one row

Translation notes: - Every right-hand operand is a member of the method argument, not of the lambda parameter, so each one becomes a bind variable. - IsPrimaryTaxId/IsMedicareBeneficiary map with CustomType<YesNoType>() (MedicareQueryHistoryMap.cs:22-23). The bound booleans are converted to 'Y'/'N'. - PersonId maps to CLAIM_PERSON_ID in this table (MedicareQueryHistoryMap.cs:14), not PERSON_ID. - Nullable operands: equality is shown as =. Depending on the NHibernate version, a comparison against a captured null may render as IS NULL. Plain = NULL would never match, so a history row with null response fields may not be found. Record this as a behavioral caveat, not a mapping fact.

Operations and processes

• Other query providers

Business rules

• SD-BR-095 Medicare history match requires all fields equal

Sources

• Data/SAIF.Data/Queries/Claims/MedicareQueryProvider.cs:30