/**
 * Terminology API Client
 *
 * HTTP client for terminology server operations ($expand, $validate-code).
 * Extracted from valueset-validator.ts for modularity.
 */
import type { TerminologyResolutionConfig, TerminologyServerOverride } from './valueset-types';
import { ValueSetCache } from './valueset-cache';
import type { CodeSystemValidationResult, SubsumptionOutcome } from './terminology-api-types';
export type { CodeSystemValidationIssue, CodeSystemValidationResult, SubsumptionOutcome, } from './terminology-api-types';
export { clearSubsumesCache, clearCodeSystemValidateCodeCache, clearValidateCodeCache, getCachedSubsumesOutcome, getSubsumesCacheSize, getValidateCodeCacheSize, } from './terminology-api-cache';
export { isSnomedNationalExtensionCode } from './terminology-code-system-result';
export declare class TerminologyApiClient {
    private config;
    private cache;
    private readonly requestConfigBuilder;
    private readonly remoteCodeSystemBudget;
    constructor(config: TerminologyResolutionConfig, cache?: ValueSetCache);
    /**
     * Update the configuration. Also invalidates the cached OAuth2
     * token so a changed auth config takes effect on the next call.
     */
    setConfig(config: TerminologyResolutionConfig): void;
    /**
     * Expand a ValueSet using a remote terminology server ($expand operation)
     * Returns null if server is unavailable or expansion fails
     */
    expandValueSet(valueSetUrl: string, override?: TerminologyServerOverride): Promise<Set<string> | null>;
    /**
     * Validate a code against a ValueSet using $validate-code
     * @param bindingStrength - If 'required', fail closed on server errors (422/404)
     */
    validateCode(code: string, system: string | undefined, valueSetUrl: string, bindingStrength?: 'required' | 'extensible' | 'preferred' | 'example', override?: TerminologyServerOverride): Promise<boolean>;
    /**
     * Validate a code directly against a CodeSystem using tx.fhir.org $validate-code
     * Used for large external CodeSystems like LOINC and SNOMED
     *
     * Uses circuit breaker to prevent flooding failing servers with requests.
     */
    validateCodeInCodeSystem(code: string, system: string, display?: string, override?: TerminologyServerOverride): Promise<CodeSystemValidationResult>;
    private executeCodeSystemValidateCodeRequest;
    private handleCodeSystemValidationError;
    /**
     * Ask the terminology server whether codeA subsumes codeB in a CodeSystem.
     * Used as a targeted fallback for filtered ValueSets such as
     * `concept is-a <snomed-code>` when a local CodeSystem tree is unavailable.
     */
    subsumes(system: string, codeA: string, codeB: string, override?: TerminologyServerOverride): Promise<SubsumptionOutcome>;
    private executeValidateCodeRequest;
    private executeSubsumesRequest;
    /**
     * Convenience: returns true when `child` is `codeB` and `parent` is
     * `codeA` and the server reports `subsumes` or `equivalent`. The
     * terminology server's argument order (codeA subsumes codeB) is easy
     * to reverse — this helper makes the intent at the call site obvious.
     */
    isSubsumedBy(system: string, child: string, parent: string, override?: TerminologyServerOverride): Promise<boolean>;
}
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