feat(api): GET /api/payers/{payer_id}/summary with 60s cache + pubsub invalidation

This commit is contained in:
Tyler
2026-06-21 12:23:19 -06:00
parent 9129543f5d
commit 50a454db59
2 changed files with 227 additions and 0 deletions
+121
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@@ -22,6 +22,7 @@ import logging
import uuid
from datetime import datetime, timezone
from contextlib import asynccontextmanager
from time import monotonic
from typing import Any, AsyncIterator
from fastapi import FastAPI, File, HTTPException, Query, Request, UploadFile
@@ -2958,6 +2959,126 @@ def list_payer_configs(payer_id: str):
return configs
# --------------------------------------------------------------------------- #
# SP21 Task 1.5: payer-level summary for the drill-down panel
# --------------------------------------------------------------------------- #
# Per-payer_id memoization for /api/payers/{payer_id}/summary. The drill-
# down UI hammers this on every hover; the underlying query is O(claims)
# per payer so a 60s TTL keeps the panel responsive. Process-local on
# purpose — invalidation is driven by the TTL alone for now (see note
# below).
_SUMMARY_TTL_S = 60.0
_summary_cache: dict[str, tuple[float, dict]] = {}
def _clear_summary_cache() -> None:
"""Test hook: wipe the process-local cache.
The 60s TTL means tests that want to assert on a recomputed payload
must clear the cache between requests. Not used by production code.
"""
_summary_cache.clear()
# Pubsub invalidation is intentionally NOT wired. The ``claim_written``
# and ``remittance_written`` payloads emitted by ``store.add`` are the
# UI-shaped dicts from ``to_ui_claim_from_orm`` / ``to_ui_remittance_from_orm``,
# neither of which carries the X12 ``payer_id`` (NM1*PR*PI qualifier).
# They carry ``payerName`` only, which is the human-readable name and not
# the URL key we cache on. Wiring a subscriber here would either need a
# DB lookup per event (re-deriving payer_id from Claim.id) or a different
# cache key — both are out of scope for this task. The 60s TTL keeps
# staleness bounded; a follow-up can wire targeted invalidation if the
# UI proves TTL-bounded staleness is unacceptable.
@app.get("/api/payers/{payer_id}/summary")
def get_payer_summary(payer_id: str):
"""Payer-level rollup for the drill-down panel.
Returns billed/received totals, denial rate, and top providers for
the given ``payer_id`` (the X12 NM1*PR*PI qualifier, e.g. ``SKCO0``).
Cached in-process for ``_SUMMARY_TTL_S`` seconds.
404 when no claims AND no remits reference this payer_id — the UI
uses that to distinguish a typo from a payer with zero traffic
(the latter would still return a valid 200 with zeroed totals).
"""
now = monotonic()
cached = _summary_cache.get(payer_id)
if cached and (now - cached[0]) < _SUMMARY_TTL_S:
return cached[1]
log.debug("payer summary cache miss", extra={"payer_id": payer_id})
# Query claims + remits scoped to this payer_id. We bypass
# ``store.iter_claims`` because that helper filters by payer NAME
# substring, not by the X12 PI qualifier we use as the URL key.
with db.SessionLocal()() as s:
claim_rows: list[Claim] = (
s.query(Claim).filter(Claim.payer_id == payer_id).all()
)
claim_ids = [c.id for c in claim_rows]
remit_rows: list[Remittance] = []
if claim_ids:
remit_rows = (
s.query(Remittance)
.filter(Remittance.claim_id.in_(claim_ids))
.all()
)
if not claim_rows and not remit_rows:
raise HTTPException(
status_code=404,
detail=f"Payer {payer_id!r} not found",
)
billed_total = sum(float(c.charge_amount or 0) for c in claim_rows)
received_total = sum(float(r.total_paid or 0) for r in remit_rows)
denied = sum(
1 for c in claim_rows if c.state == ClaimState.DENIED
)
claim_count = len(claim_rows)
denial_rate = (denied / claim_count) if claim_count else 0.0
provider_counts: dict[str, int] = {}
for c in claim_rows:
npi = c.provider_npi
if not npi:
continue
provider_counts[npi] = provider_counts.get(npi, 0) + 1
top_providers = [
{"npi": npi, "count": count}
for npi, count in sorted(
provider_counts.items(), key=lambda kv: -kv[1]
)[:5]
]
# Best-effort payer display name from the first claim's raw
# payer object (NM1*PR name element, e.g. "COHCPF"). Falls
# back to the id when no parsed envelope is available.
payer_name = payer_id
for c in claim_rows:
raw = c.raw_json or {}
p = raw.get("payer") if isinstance(raw, dict) else None
if isinstance(p, dict) and p.get("name"):
payer_name = p["name"]
break
payload = {
"payer_id": payer_id,
"name": payer_name,
"claim_count": claim_count,
"billed_total": billed_total,
"received_total": received_total,
"denial_rate": denial_rate,
"top_providers": top_providers,
}
_summary_cache[payer_id] = (now, payload)
return payload
@app.post("/api/admin/reload-config")
def reload_config():
"""Re-read ``config/payers.yaml`` and revalidate. Returns counts."""