TABLE 1.
PCNP (N=85,820) | PCMD (N=382,124) | |||||||
---|---|---|---|---|---|---|---|---|
Service Category | Total Service Units | Units of Service Per Beneficiary | Mean Allowed Amount Per Unit | Mean Expected Allowed Amount Per Unit | Total Service Units | Units of Service Per Beneficiary | Mean Allowed Amount Per Unit | Mean Expected Allowed Amount Per Unit |
Durable medical equipment | 3172 | 0.04 | $121 | $47 | 19,885 | 0.05 | $96 | $44 |
Standard imaging | 343,865 | 4.01 | $44 | $56 | 2,046,006 | 5.35 | $43 | $47 |
Advanced imaging | 64,426 | 0.75 | $110 | $125 | 425,765 | 1.11 | $119 | $117 |
Office visit | 493,113 | 5.75 | $57 | $88 | 3,437,565 | 9.00 | $62 | $78 |
Home visit | 32,553 | 0.38 | $94 | $143 | 43,873 | 0.11 | $95 | $130 |
Specialist visit | 170,732 | 1.99 | $60 | $80 | 733,543 | 1.92 | $71 | $80 |
Consultation | 7 | 0.00 | $158 | $315 | 68 | 0.00 | $114 | $127 |
Other OP visit | 680,470 | 7.93 | $93 | $117 | 2,921,426 | 7.65 | $118 | $122 |
General services | 195,036 | 2.27 | $207 | $171 | 1,109,755 | 2.90 | $193 | $145 |
Anesthesia | 24,271 | 0.28 | $176 | $152 | 169,362 | 0.44 | $185 | $147 |
Major procedures | 29,721 | 0.35 | $608 | $436 | 210,229 | 0.55 | $624 | $433 |
Minor procedures | 240,171 | 2.80 | $76 | $74 | 1,473,579 | 3.86 | $84 | $69 |
Endoscopy, oncology, and dialysis | 42,184 | 0.49 | $221 | $180 | 289,985 | 0.76 | $233 | $172 |
Ordinary lab test | 885,387 | 10.32 | $22 | $31 | 4,184,198 | 10.95 | $24 | $28 |
Other lab test | 112,991 | 1.32 | $40 | $49 | 834,901 | 2.18 | $41 | $42 |
Other Medicare | 119,575 | 1.39 | $14 | $21 | 314,275 | 0.82 | $18 | $24 |
PCMD indicates primary care physicians; PCNP, primary care nurse practitioners.