URSA-PHF-R12: Registry of Primary Care Office Visits

  • Published on Apr 23, 2026
  • 10 minute(s) read
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Measure Description

One record per Primary Care Office Visit with published characteristics about the patient (plan membership, chronic conditions, etc.) as of the encounter date as well as flag for whether the visit was with a plan or empirically attributed provider.

Metadata

  • Measure Identifier: URSA-PHF-R12
  • Measure Type: Registry
  • Temporal Structure: Event
  • Component Class: Normal-Form
  • Denominator Case Field: Encounter ID
  • Target Direction: None

Published Fields

  • Data Model Keys

    • Encounter ID -- The internal database identifier (used, e.g., for joins and primary keys) for the encounter. (See also [URSA-CORE] Encounter)
    • 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)
    • Encounter Primary Payor ID -- Data model key for the primary payor documented in the billing for an encounter.
    • Encounter Primary Plan ID -- Data model key for the primary plan documented in the billing for an encounter.
    • Facility Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the facility provider. (See also [URSA-CORE] Facility Provider)
    • Service Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the service provider. (See also [URSA-CORE] Service Provider)
    • Attending Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the attending provider. (See also [URSA-CORE] Attending Provider)
    • Provider Group Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the provider group. (See also [URSA-CORE] Provider Group)
    • Prior Primary Care Office Visit Encounter ID
    • Patient Primary Payor ID
    • Patient Primary Plan ID

  • Patient Fields

    • Patient Date of Birth -- The patient's date of birth. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the date of birth found on that particular type of record in the source data.
    • Patient Age Integer -- Patient age, expressed as an integer, as of a reference date or interval.
    • Patient Age Category Tier 1 -- Non-overlapping ranges of the patient age in years into three categories; [01] Pediatrics < 19, [02] Adults 19 - 64, and [03] Older Adults >= 65. Coarser grain to the Patient Age Category Tier 2. (See also [URSA-CORE] Patient Age Category Tier 2)
    • Patient Age Category Tier 2 -- Non-overlapping ranges of the patient age in years representing finer grain categories than the Patient Age Category Tier 1. This field incorporates findings from publications on defining meaningful age groups in the context of disease. These ranges closely, but not exactly, align with standard age ranges such as those defined by the Medical Subject Headings (MeSH). See results of K-Means simple clustering method at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825015/ (See also [URSA-CORE] Patient Age Category Tier 1)
    • Patient Sex Category
    • PCP Attribution Category
    • Primary Care Engagement Category
    • Specialty Care Engagement Category
    • Primary or Specialty Care Engagement Category

  • Date Fields

    • Encounter Date
    • Prior Primary Care Office Visit Encounter Date
    • Days Since Prior Primary Care Office Visit
    • Current Continuous Primary Payor Membership Episode Start Date -- The start date of the Continuous Primary Payor Membership Episode in effect as of the (potentially historical) period covered by the record. (See also [URSA-CORE] Continuous Primary Payor Membership Episode)
    • Current Continuous Primary Payor Membership Episode End Date -- The end date of the Continuous Primary Payor Membership Episode in effect as of the (potentially historical) period covered by the record. Values follow the standard exclusive convention for Period End Dates. (See also [URSA-CORE] Continuous Primary Payor Membership Episode, [URSA-CORE] Period End Date)
    • 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)

  • Encounter Fields

    • Is Preventive Care Visit from Non-Primary Care Specialist
    • Is Annual Wellness Visit
    • Is First AWV with Provider
    • Is Subsequent AWV with Provider
    • Is Initial Preventive Physician Examination (IPPE)
    • Is FQHC Visit for IPPE or AWV
    • Is Urgent Care Visit -- Indicates the encounter had one or more claim document with a HCPCS, Revenue Center Code, or Place of Service Code specific to Urgent Care Facility claim filing.
    • Is FQHC Encounter

  • Provider Fields

    • Is Any Provider Qualifying Primary Care Provider
    • Service Provider Provider NPI
    • Service Provider Provider Description
    • Service Provider Primary NUCC Provider Taxonomy Code
    • Service Provider Primary NUCC Provider Taxonomy Description
    • Service Provider Affiliated Provider Group Description
    • Provider Group Description
    • Provider Group Primary NUCC Provider Taxonomy Description
    • Ursa Service Provider Specialty Type Category
    • Is RHC Encounter
    • Primary Plan Attributee Provider Description
    • Empirical Attributee Primary Care Individual Provider Description
    • Empirical Attributee Primary Care Provider Group Provider Description

  • Location Fields

    • Service Provider Practice Address State Abbreviation
    • Service Provider Practice Address ZIP Code 5-Digit
    • Provider Group Practice Address State Abbreviation
    • Provider Group Practice Address ZIP Code 5-Digit

  • Insurance Fields

    • Is Any Current Plan Membership
    • Patient Primary Payor Description
    • Patient Primary Plan Description
    • Primary Plan Financial Class Description

  • Clinical Services Fields

    • Qualifying Document HCPCS Code
    • Qualifying Preventive Primary Care HCPCS Code
    • Qualifying Preventive Primary Care HCPCS Code Description
    • Qualifying Annual Wellness Visit HCPCS Code
    • Qualifying Annual Wellness Visit HCPCS Code Description

  • Diagnosis Fields

    • Principal Discharge Diagnosis ICD-10-CM Code
    • Principal Discharge Diagnosis ICD-10-CM Description
    • Principal Discharge Diagnosis WHO ICD-10 Chapter Description
    • Principal Discharge Diagnosis WHO ICD-10 Block Description
    • Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Code
    • Principal Discharge Diagnosis AHRQ CCS Single-Level Diagnosis Category Description
    • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Code
    • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 1 Description
    • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Code
    • Principal Discharge Diagnosis AHRQ CCS Multi-Level Diagnosis Category Tier 2 Description
    • CCW Count Category
    • Count CCW Conditions -- The total of both Chronic Conditions and Potentially Disabling Events included in the CMS Chronic Condition Warehouse (CCW) library. (See also [URSA-CORE] CCW Comorbidity Category, [URSA-CORE] Count Potentially Disabling Events, [URSA-CORE] CMS Chronic Condition Warehouse (CCW), [URSA-CORE] Count Chronic Conditions)
    • CCW Systems Category
    • Count CCW Systems -- The count of distinct systems of the body with one or more active CCW Condition. CCW Systems are as a parent category to the individual CCW Conditions grouping them based primarily on the human body system they impact such as; Behavioral Health, Cancers, Cardiovascular, Cerebrovascular, Endocrine, Genitourinary, Musculoskeletal, and Pulmonary. (See also [URSA-CORE] CMS Chronic Condition Warehouse (CCW))
    • Is CCW System Behavioral Health -- Indicates the patient has one or more of the following CCW conditions; ADHD, Conduct Disorders, and Hyperkinetic Syndrome, Anxiety Disorders, Autism Spectrum Disorder, Bipolar Disorder, Depression, Depressive Disorders, Personality Disorders, PTSD, Schizophrenia, or Schizophrenia and Other Psychotic Disorders.
    • Is CCW System Cardiovascular -- Indicates the patient has one or more of the following CCW conditions; Acute Myocardial Infarction (AMI), Atrial Fibrillation, Heart Failure, Hypertension, Ischemic Heart Disease, or Peripheral Vascular Disease (PVD).
    • Is CCW System Congenital -- Indicates the patient has one or more of the following CCW conditions; Cerebral Palsy, Cystic Fibrosis and Other Metabolic Disorder, Intellectual Disability, Learning Disability, Muscular Dystrophy, or Other Developmental Delays.
    • Is CCW System Endocrine/Metabolic -- Indicates the patient has one or more of the following CCW conditions; Diabetes, Acquired Hypothyroidism, Hyperlipidemia, or Obesity.
    • Is CCW System Genitourinary -- Indicates the patient has one or more of the following CCW conditions; Benign Prostatic Hyperplasia or Chronic Kidney Disease (CKD).
    • Is CCW System Hematologic -- Indicates the patient has one or more of the following CCW conditions; Anemia.
    • Is CCW System Musculoskeletal -- Indicates the patient has one or more of the following CCW conditions; Hip or Pelvic Fracture, Rheumatoid Arthritis or Osteoarthritis, or Osteoporosis.
    • Is CCW System Neurological -- Indicates the patient has one or more of the following CCW conditions; Alzheimer's Disease, Alzheimer's Disease and Related Disorders or Senile Dementia, Stroke or Transient Ischemic Attack, Epilepsy, Migraine and Chronic Headache, Mobility Impairment, Multiple Sclerosis, or Deafness and Hearing Impairment.
    • Is CCW System Oncologic -- Indicates the patient has one or more of the following CCW conditions; Breast Cancer, Colorectal Cancer, Endometrial Cancer, Lung Cancer, Prostate Cancer, or Leukemia.
    • Is CCW System Ophthalmologic -- Indicates the patient has one or more of the following CCW conditions; Cataract, Glaucoma, or Blindness and Visual Impairment.
    • Is CCW System Pulmonary -- Indicates the patient has one or more of the following CCW conditions; Asthma, or Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis.
    • Is CCW System Other -- Indicates the patient has one or more of the following CCW conditions; Fibromyalgia and Chronic Pain and Fatigue, Pressure or Chronic Ulcer.

  • Billing and Claims Fields

    • CMS Admit Type Description -- The natural language of a standard CMS Admit Type or Type of Admission Code; 1 = Emergency, 2 = Urgent, 3 = Elective, 4 = Newborn, 5 = Trauma Center, 9 = Information Not Available. (See also [URSA-CORE] CMS Admit Type Code)
    • CMS Admit Source Description -- The natural language description of a standard CMS Admit Source code. (See also [URSA-CORE] CMS Admit Source Code)
    • CMS Patient Discharge Status Description -- The natural language description of a standard CMS Patient Discharge Status code. (See also [URSA-CORE] CMS Patient Discharge Status Code)
    • Qualifying Document CMS Revenue Center Code
    • CMS Place of Service Code -- The standard CMS 2-digit Place of Service code; e.g., 01 = Pharmacy, 02 = Telehealth, etc.
    • CMS Admit Type Code -- The standard single-digit CMS inpatient admission type code found on Inpatient and Skilled Nursing Facility claims; ; 1 = Emergency, 2 = Urgent, 3 = Elective, 4 = Newborn, 5 = Trauma Center, 9 = Information Not Available.
    • CMS Admit Source Code -- The standard 1-character CMS Admit Source code; e.g., 1 = Physician Referral, 2 = Clinic Referral, etc.
    • CMS Patient Discharge Status Code -- The standard 2-digit CMS Patient Discharge Status code; 01 = Discharged to Home or Self Care, etc. Patient Discharge Status codes should include leading zeros.
    • CMS Place of Service Description -- The natural language description of a standard CMS Place of Service code (See also [URSA-CORE] CMS Place of Service Code)

  • Financial Fields

    • Encounter Total Plan Paid Amount from All Plans Category
    • Primary Plan Allowed Amount -- The maximum amount that the payor agrees to pay the provider for a service or product, typically governed by a contract. The Allowed Amount for a claim or billing record is calculated by adding the Contractual Adjustment Amount (which is typically negative) to the Charge Amount. Adding the total Non-Contractual Adjustment Amount to the Allowed Amount yields the Total Due Amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Allowed Amount, Secondary Plan Allowed Amount, and Tertiary Plan Allowed Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively. (See also [URSA-CORE] Charge Amount, [URSA-CORE] Contractual Adjustment Amount, [URSA-CORE] Non-Contractual Adjustment Amount, [URSA-CORE] Total Due Amount)
    • Primary Plan Paid Amount -- The amount actually paid by the health plan to the provider for a service or product. Subtracting the plan paid amount from the total due amount typically yields the patient responsibility amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Paid Amount, Secondary Plan Paid Amount, and Tertiary Plan Paid Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively; the total paid by any and all plans on a bill is identified by the Any Plan Paid Amount field.
    • Total Plan Paid Amount from All Plans
    • Patient Paid Amount -- The amount paid by the patient to the provider for health care services or products.

  • Metadata Fields

    • Qualifying Document EMR Encounter Type Description
    • Is Qualifying Preventive Primary Care Service
    • Is Qualifying Primary Care Service Provider
    • Is Qualifying Primary Care Attending Provider
    • Is Qualifying Primary Care Provider Group
    • Is Qualifying Primary Care Facility Provider

  • Measure Fields

    • Is Visit with Primary Plan Attributee Provider
    • Is Visit with Empirical Attributee Primary Care Individual
    • Is Visit with Empirical Attributee Primary Care Provider Group