When we score measure #48 with a performance of 100 we are seeing 7 points because  "Applied maximum points for Topped Out measure".
     "category": "quality",
      "submissionMethod": "registry",
      "performanceStart": "2019-01-01",
      "performanceEnd": "2019-12-31",
      "measurements": [
        {
          "measureId": "048",
          "value": {
            "isEndToEndReported": false,
            "performanceMet": 150,
            "performanceNotMet": 0,
            "eligiblePopulation": 150,
            "eligiblePopulationException": 0
                    "metadata": {
                      "performanceRate": 100,
                      "reportingRate": 100,
                      "measureClass": "Class 1",
                      "measureTitle": "Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older",
                      "endToEndBonusEligible": false,
                      "endToEndBonus": 0,
                      "outcomeOrPatientExperienceBonus": 0,
                      "highPriorityBonus": 0,
                      "decileScore": 7,
                      "performanceDenominator": 150,
                      "performanceNumerator": 150,
                      "eligiblePopulation": 150,
                      "partialDecileScore": 0,
                      "partialPoints": 15.79,
                      "decile": 7,
                      "deciles": [
                        0,
                        12.2,
                        31.75,
                        51.72,
                        70.45,
                        84.21,
                        95.11,
                        99.51,
                        100
                      ],
                      "processingStatus": "PICKED",
                      "totalMeasurementPoints": 7,
                      "totalBonusPoints": 0,
                      "messages": {
                        "measurementClass": "Eligible population is greater than or equal to 20, reporting rate is greater than 60% and has benchmarks",
                        "decileScore": "Applied maximum points for Topped Out measure",
                        "e2eBonusScore": "Default E2E bonus score",
                        "measurementPicker": "Picked at 1",
                        "totalMeasurementPoints": "Measurement points for PICKED measure include decile score with all bonus points"
                      },
                      "noBenchmarks": false,
                      "benchmarkType": "registry",
                      "eMeasureId": null,
                      "toppedOut": false,
                      "isGhost": false,
                      "submissionMethod": "registry",
                      "performanceStart": "2019-01-01",
                      "performanceEnd": "2019-12-31",
                      "unroundedScoreValue": 7
However #48 is only topped out for claims but it is not topped out for registry submissions: