Report Identifier: |
Description: |
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(A) Total Unique Medicare ID Count |
Total number of beneficiaries for whom the provider rendered a service -- regardless of the procedure code(s) billed |
Procedure Code |
The Current Procedural Technology® (CPT) code and short descriptor defining the services billed |
(B) Unique Medicare IDs |
The total number of beneficiaries for whom the provider furnished the individual service -- organized by CPT®/procedure code |
(C) Svcs. |
The total number of services per procedure code that was billed by the provider -- regardless of the number of beneficiaries served by the provider’s practice |
(D) Allw. Svcs. |
The total number of allowed services per procedure code, -- regardless of the number of beneficiaries served by the provider’s practice |
(E) Peer (Percentage of Services) |
The percentage of the specific service to all services rendered. Calculated by: Total services billed by provider’s Peer Group or Specialty for a specific service divided by the total services billed for all services rendered y provider’s Peer Group or Specialty multiplied by 100 |
(F) PIN (Percentage of Services) |
The percentage of the specific service rendered by the provider to all services rendered by the provider Calculated by: Total services for a specific service -- Column (C) -- divided by the total of Column (C) multiplied by 100 |
(G) Peer (Ratio I) |
A statistical comparison of a specific service rendered within a provider’s Peer Group or Specialty for all beneficiaries serviced by that Peer Group or Specialty Calculated by: Total services billed for a specific service for all providers in the Peer Group or Specialty divided by the total number of beneficiaries serviced by the Peer Group or Specialty |
(H) PIN (Ratio I) |
A statistical comparison of a specific service rendered by the provider to all beneficiaries serviced by that provider Calculated by: Total services billed for a specific service -- Column (C) -- divided by the provider’s total beneficiary population -- Column (A) |
(I) Peer (Ratio II) |
A statistical comparison of the number of times the provider’s Peer Group or Specialty rendered a specific service to each beneficiary who received that service Calculated by: Total number of services billed for a specific service divided by the number of beneficiaries who received the service |
(J) PIN (Ratio II) |
A statistical comparison of the number of times the provider rendered a specific service to each beneficiary who received that service Calculated by: Total number of services billed for a specific service -- Column (C) -- divided by the number of beneficiaries who received the service -- Column (B) |
(K) Allowed Dollars |
The total allowed dollars for the claims submitted by the provider for each individual procedure code detailed within the table |
(L) Peer (Percentage Allowed) |
A comparison (by percentage) of the total allowed dollars for a specific service for all providers within the provider’s Peer Group or Specialty to all allowed dollars for all services in the provider’s Peer Group or Specialty Calculated by: The total allowed dollars for a specific service divided by the total allowed dollars for all services |
(M) PIN (Percentage Allowed) |
A comparison (by percentage) of the total allowed dollars for a specific service the provider rendered to all allowed dollars for all services the provider rendered Calculated by: The total allowed dollars for a specific service -- Column (K) -- divided by the total allowed dollars for all services -- total of Column (K) |