URSA-CORE-906: Professional Claims with Single Paid Line Item

Measure Description

Among professional claims with at least one line item with a positive plan paid amount and 4 or more lines, the percentage with exactly one line item with a positive plan paid amount.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case Field: Claim ID
• Target Direction: Down

Denominator Description

Professional claims with at least one line item with a positive plan paid amount and 4 or more lines

Numerator Description

Denominator observations with exactly one line item with a positive plan paid amount