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."""
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@@ -0,0 +1,106 @@
"""Tests for GET /api/payers/{payer_id}/summary (SP21 Task 1.5).
The endpoint is the payer-level aggregate that the drill-down UI's
"Payer → Claims" panel hangs off. It returns billed/received totals,
denial rate, and the top 5 NPIs by claim volume for one payer_id,
cached in-process for 60s.
The minimal 837P fixture ships one CLM with ``payer_id="SKCO0"``,
charge_amount=100.00; the minimal 835 carries one CLP for the same
claim with total_paid=85.00. So ``/api/payers/SKCO0/summary`` returns
``claim_count >= 1`` after both files are ingested.
Note: the spec calls this ``payer_id`` (the X12 NM1*PR*PI qualifier,
e.g. ``SKCO0``). It is NOT the configured payer name from
``config/payers.yaml``. The filter key in the store layer is
``Claim.payer_id`` — not the ``payer=`` substring filter used by
``/api/claims?payer=...``.
"""
from __future__ import annotations
from pathlib import Path
import pytest
from fastapi.testclient import TestClient
from cyclone import api as api_mod
from cyclone.api import app
FIXTURE_837 = Path(__file__).parent / "fixtures" / "minimal_837p.txt"
FIXTURE_835 = Path(__file__).parent / "fixtures" / "minimal_835.txt"
@pytest.fixture(autouse=True)
def _clear_summary_cache():
"""Wipe the in-process payer-summary cache between tests.
conftest resets the DB per test but the cache is module-level
state on ``cyclone.api``. Without this clear, a stale payload
from a previous test's seed would leak into a later test's first
call — masking recompute behavior. The 60s TTL is the only
invalidation story today (see api.py docstring on the endpoint).
"""
api_mod._clear_summary_cache()
yield
api_mod._clear_summary_cache()
@pytest.fixture
def client() -> TestClient:
return TestClient(app)
@pytest.fixture
def seeded_db(client: TestClient):
"""Ingest one minimal 837P + one minimal 835.
Both fixtures carry ``payer_id="SKCO0"`` so the summary endpoint
has something to aggregate. ``client`` is yielded back so the
test can hit the API on the same TestClient that ingested the
fixtures (parses share the per-test SQLite from conftest).
"""
text_837 = FIXTURE_837.read_text()
text_835 = FIXTURE_835.read_text()
r837 = client.post(
"/api/parse-837",
files={"file": ("x.txt", text_837, "text/plain")},
headers={"Accept": "application/json"},
)
assert r837.status_code == 200, r837.text
r835 = client.post(
"/api/parse-835",
files={"file": ("era.txt", text_835, "text/plain")},
headers={"Accept": "application/json"},
)
assert r835.status_code == 200, r835.text
return client
def test_payer_summary_happy_path(seeded_db: TestClient):
"""Seeded db has at least one claim for SKCO0 → 200 with the spec shape."""
resp = seeded_db.get("/api/payers/SKCO0/summary")
assert resp.status_code == 200, resp.text
data = resp.json()
assert data["payer_id"] == "SKCO0"
assert "claim_count" in data
assert "billed_total" in data
assert "received_total" in data
assert "denial_rate" in data
assert data["claim_count"] >= 1
# denial_rate must be a float in [0, 1] (0/1 claim → 0.0).
assert isinstance(data["denial_rate"], (int, float))
assert 0.0 <= data["denial_rate"] <= 1.0
def test_payer_summary_unknown_payer_returns_404(client: TestClient):
resp = client.get("/api/payers/DOES_NOT_EXIST/summary")
assert resp.status_code == 404
def test_payer_summary_caches_then_invalidates(seeded_db: TestClient):
"""Two back-to-back calls return identical payloads (in-process cache)."""
resp1 = seeded_db.get("/api/payers/SKCO0/summary")
resp2 = seeded_db.get("/api/payers/SKCO0/summary")
assert resp1.status_code == 200
assert resp2.status_code == 200
assert resp1.json() == resp2.json()