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. 2020 Dec 2;59(2):177–184. doi: 10.1097/MLR.0000000000001477

TABLE 1.

Mix of Services & Mean Allowed Amounts for Beneficiaries Attributed to PCNPs and PCMDs

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.