URSA-CORE-940: Pharmacy Claims with Critical Missing Data

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Measure Description

Among pharmacy claim records, the percentage with at least one unpopulated critical field; critical fields are: Patient ID, Filling Provider ID, Filled Date, NDC, and Days Supply.

Metadata

  • Measure Identifier: URSA-CORE-940
  • Measure Type: Rate Measure
  • Temporal Structure: Event
  • Component Class: Normal-Form
  • Denominator Case Field: Document ID
  • Target Direction: Down

Denominator Description

One per pharmacy claim record.

Numerator Description

One per qualifying denominator observation with at least one unpopulated critical field; critical fields are: Patient ID, Filling Provider ID, Filled Date, NDC, and Days Supply.

Published Fields

  • Data Model Keys

    • Document ID -- The internal database identifier (used, e.g., for joins and primary keys) for the document. (See also [URSA-CORE] Document)
    • Claim ID -- The internal database identifier (used, e.g., for joins and primary keys) for the claim. (See also [URSA-CORE] Claim)
    • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
    • Filling Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the filling provider.
    • Source ID -- The identifier for the original source data system from which the current record originated.
    • Payor ID -- The identifier for the health insurance organization associated with the current record.
    • Plan ID -- The identifier for a particular health insurance plan product offered by a payor.
  • Date Fields

    • Filled Date -- The date a prescription or medication order was filled, with medications dispensed.
    • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
    • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Medication Fields

    • NDC Code 11-Digit -- The standard 11-digit National Drug Code; e.g., 00045012400 = Tylenol 500 mg.
    • Label Description -- Supplies the name given to the product by the manufacturer.
    • Days Supply -- The number of calendar days, including the date the medication was dispensed, the dispensed medication will last at the patient's intended dosage as defined in their prescription.
  • Numerator Fields

    • Is Patient ID NULL
    • Is Filling Provider ID NULL
    • Is Filled Date NULL
    • Is NDC Code NULL
    • Is Days Supply NULL
  • Measure Fields

    • Denominator