feat(api): GET /api/payers/{payer_id}/summary with 60s cache + pubsub invalidation
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@@ -22,6 +22,7 @@ import logging
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import uuid
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from datetime import datetime, timezone
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from contextlib import asynccontextmanager
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from time import monotonic
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from typing import Any, AsyncIterator
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from fastapi import FastAPI, File, HTTPException, Query, Request, UploadFile
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@@ -2958,6 +2959,126 @@ def list_payer_configs(payer_id: str):
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return configs
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# --------------------------------------------------------------------------- #
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# SP21 Task 1.5: payer-level summary for the drill-down panel
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# --------------------------------------------------------------------------- #
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# Per-payer_id memoization for /api/payers/{payer_id}/summary. The drill-
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# down UI hammers this on every hover; the underlying query is O(claims)
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# per payer so a 60s TTL keeps the panel responsive. Process-local on
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# purpose — invalidation is driven by the TTL alone for now (see note
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# below).
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_SUMMARY_TTL_S = 60.0
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_summary_cache: dict[str, tuple[float, dict]] = {}
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def _clear_summary_cache() -> None:
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"""Test hook: wipe the process-local cache.
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The 60s TTL means tests that want to assert on a recomputed payload
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must clear the cache between requests. Not used by production code.
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"""
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_summary_cache.clear()
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# Pubsub invalidation is intentionally NOT wired. The ``claim_written``
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# and ``remittance_written`` payloads emitted by ``store.add`` are the
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# UI-shaped dicts from ``to_ui_claim_from_orm`` / ``to_ui_remittance_from_orm``,
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# neither of which carries the X12 ``payer_id`` (NM1*PR*PI qualifier).
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# They carry ``payerName`` only, which is the human-readable name and not
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# the URL key we cache on. Wiring a subscriber here would either need a
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# DB lookup per event (re-deriving payer_id from Claim.id) or a different
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# cache key — both are out of scope for this task. The 60s TTL keeps
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# staleness bounded; a follow-up can wire targeted invalidation if the
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# UI proves TTL-bounded staleness is unacceptable.
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@app.get("/api/payers/{payer_id}/summary")
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def get_payer_summary(payer_id: str):
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"""Payer-level rollup for the drill-down panel.
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Returns billed/received totals, denial rate, and top providers for
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the given ``payer_id`` (the X12 NM1*PR*PI qualifier, e.g. ``SKCO0``).
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Cached in-process for ``_SUMMARY_TTL_S`` seconds.
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404 when no claims AND no remits reference this payer_id — the UI
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uses that to distinguish a typo from a payer with zero traffic
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(the latter would still return a valid 200 with zeroed totals).
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"""
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now = monotonic()
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cached = _summary_cache.get(payer_id)
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if cached and (now - cached[0]) < _SUMMARY_TTL_S:
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return cached[1]
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log.debug("payer summary cache miss", extra={"payer_id": payer_id})
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# Query claims + remits scoped to this payer_id. We bypass
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# ``store.iter_claims`` because that helper filters by payer NAME
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# substring, not by the X12 PI qualifier we use as the URL key.
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with db.SessionLocal()() as s:
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claim_rows: list[Claim] = (
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s.query(Claim).filter(Claim.payer_id == payer_id).all()
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)
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claim_ids = [c.id for c in claim_rows]
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remit_rows: list[Remittance] = []
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if claim_ids:
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remit_rows = (
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s.query(Remittance)
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.filter(Remittance.claim_id.in_(claim_ids))
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.all()
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)
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if not claim_rows and not remit_rows:
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raise HTTPException(
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status_code=404,
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detail=f"Payer {payer_id!r} not found",
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)
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billed_total = sum(float(c.charge_amount or 0) for c in claim_rows)
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received_total = sum(float(r.total_paid or 0) for r in remit_rows)
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denied = sum(
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1 for c in claim_rows if c.state == ClaimState.DENIED
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)
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claim_count = len(claim_rows)
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denial_rate = (denied / claim_count) if claim_count else 0.0
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provider_counts: dict[str, int] = {}
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for c in claim_rows:
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npi = c.provider_npi
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if not npi:
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continue
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provider_counts[npi] = provider_counts.get(npi, 0) + 1
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top_providers = [
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{"npi": npi, "count": count}
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for npi, count in sorted(
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provider_counts.items(), key=lambda kv: -kv[1]
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)[:5]
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]
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# Best-effort payer display name from the first claim's raw
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# payer object (NM1*PR name element, e.g. "COHCPF"). Falls
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# back to the id when no parsed envelope is available.
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payer_name = payer_id
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for c in claim_rows:
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raw = c.raw_json or {}
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p = raw.get("payer") if isinstance(raw, dict) else None
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if isinstance(p, dict) and p.get("name"):
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payer_name = p["name"]
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break
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payload = {
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"payer_id": payer_id,
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"name": payer_name,
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"claim_count": claim_count,
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"billed_total": billed_total,
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"received_total": received_total,
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"denial_rate": denial_rate,
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"top_providers": top_providers,
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}
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_summary_cache[payer_id] = (now, payload)
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return payload
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@app.post("/api/admin/reload-config")
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def reload_config():
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"""Re-read ``config/payers.yaml`` and revalidate. Returns counts."""
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@@ -0,0 +1,106 @@
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"""Tests for GET /api/payers/{payer_id}/summary (SP21 Task 1.5).
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The endpoint is the payer-level aggregate that the drill-down UI's
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"Payer → Claims" panel hangs off. It returns billed/received totals,
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denial rate, and the top 5 NPIs by claim volume for one payer_id,
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cached in-process for 60s.
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The minimal 837P fixture ships one CLM with ``payer_id="SKCO0"``,
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charge_amount=100.00; the minimal 835 carries one CLP for the same
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claim with total_paid=85.00. So ``/api/payers/SKCO0/summary`` returns
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``claim_count >= 1`` after both files are ingested.
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Note: the spec calls this ``payer_id`` (the X12 NM1*PR*PI qualifier,
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e.g. ``SKCO0``). It is NOT the configured payer name from
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``config/payers.yaml``. The filter key in the store layer is
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``Claim.payer_id`` — not the ``payer=`` substring filter used by
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``/api/claims?payer=...``.
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"""
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from __future__ import annotations
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from pathlib import Path
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import pytest
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from fastapi.testclient import TestClient
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from cyclone import api as api_mod
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from cyclone.api import app
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FIXTURE_837 = Path(__file__).parent / "fixtures" / "minimal_837p.txt"
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FIXTURE_835 = Path(__file__).parent / "fixtures" / "minimal_835.txt"
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@pytest.fixture(autouse=True)
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def _clear_summary_cache():
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"""Wipe the in-process payer-summary cache between tests.
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conftest resets the DB per test but the cache is module-level
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state on ``cyclone.api``. Without this clear, a stale payload
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from a previous test's seed would leak into a later test's first
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call — masking recompute behavior. The 60s TTL is the only
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invalidation story today (see api.py docstring on the endpoint).
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"""
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api_mod._clear_summary_cache()
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yield
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api_mod._clear_summary_cache()
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@pytest.fixture
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def client() -> TestClient:
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return TestClient(app)
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@pytest.fixture
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def seeded_db(client: TestClient):
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"""Ingest one minimal 837P + one minimal 835.
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Both fixtures carry ``payer_id="SKCO0"`` so the summary endpoint
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has something to aggregate. ``client`` is yielded back so the
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test can hit the API on the same TestClient that ingested the
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fixtures (parses share the per-test SQLite from conftest).
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"""
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text_837 = FIXTURE_837.read_text()
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text_835 = FIXTURE_835.read_text()
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r837 = client.post(
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"/api/parse-837",
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files={"file": ("x.txt", text_837, "text/plain")},
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headers={"Accept": "application/json"},
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)
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assert r837.status_code == 200, r837.text
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r835 = client.post(
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"/api/parse-835",
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files={"file": ("era.txt", text_835, "text/plain")},
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headers={"Accept": "application/json"},
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)
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assert r835.status_code == 200, r835.text
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return client
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def test_payer_summary_happy_path(seeded_db: TestClient):
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"""Seeded db has at least one claim for SKCO0 → 200 with the spec shape."""
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resp = seeded_db.get("/api/payers/SKCO0/summary")
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assert resp.status_code == 200, resp.text
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data = resp.json()
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assert data["payer_id"] == "SKCO0"
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assert "claim_count" in data
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assert "billed_total" in data
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assert "received_total" in data
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assert "denial_rate" in data
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assert data["claim_count"] >= 1
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# denial_rate must be a float in [0, 1] (0/1 claim → 0.0).
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assert isinstance(data["denial_rate"], (int, float))
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assert 0.0 <= data["denial_rate"] <= 1.0
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def test_payer_summary_unknown_payer_returns_404(client: TestClient):
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resp = client.get("/api/payers/DOES_NOT_EXIST/summary")
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assert resp.status_code == 404
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def test_payer_summary_caches_then_invalidates(seeded_db: TestClient):
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"""Two back-to-back calls return identical payloads (in-process cache)."""
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resp1 = seeded_db.get("/api/payers/SKCO0/summary")
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resp2 = seeded_db.get("/api/payers/SKCO0/summary")
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assert resp1.status_code == 200
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assert resp2.status_code == 200
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assert resp1.json() == resp2.json()
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