Note: Billing relationships are defined as an instance of an EP billing under a given TIN. Each EP can have multi

Table 4. EP Specialty Composition of Each Cost Range for TINs with 1+ EPs and 20+ Beneficiaries - Specialty Wei

Low Medium

Medical oncology 94% 3,709 0.3% 73.4%

Hematology/oncology 90% 10,165 0.8% 80.4%

Geriatric Psychiatry 44% 57 0.0% 82.5%

Surgical oncology 81% 833 1.4% 81.5%

Radiation oncology 56% 3,668 2.5% 80.9%

Unknown physician specialty 54% 167 0.6% 83.2%

Hematology 92% 1,101 0.6% 84.1%

Gynecologist/oncologist 76% 1,040 1.7% 83.1%

Geriatric medicine 93% 2,594 1.3% 83.6%

Neurosurgery 67% 3,742 1.5% 85.0%

Pain Management 56% 1,011 1.6% 85.9%

Internal medicine 83% 111,258 1.6% 87.1%

Certified clinical nurse specialist 43% 1,275 2.8% 86.2%

Hospice and Palliative Care 81% 323 0.3% 89.2%

Nurse practitioner 71% 51,965 5.5% 84.1%

Physical medicine and rehabilitation 57% 5,593 2.5% 87.5%

General practice 64% 8,283 6.4% 83.9%

Osteopathic manipulative therapy 57% 457 5.3% 85.3%

Single or Multispecialty clinic or group practice 36% 3,145 5.6% 85.0%

Clinical psychologist (billing indepedently) 4% 32 12.5% 78.1%

General surgery 63% 17,149 1.7% 89.4%

Clinical psychologist 15% 4,594 3.9% 87.9%

Licensed clinical social worker 13% 4,726 9.1% 82.7%

Physician assistant 70% 42,108 3.1% 88.9%

Certified Registered Nurse Anesthetists (CRNA) 31% 16,209 1.0% 91.0%

Colorectal surgery 59% 957 3.8% 88.3%

Thoracic surgery 62% 1,889 0.2% 92.0%

Interventional Pain Management 58% 1,893 3.1% 89.1%

Chiropractic 2% 843 2.8% 89.4%

Speech-language pathologist 28% 369 5.1% 87.3%

Emergency medicine 37% 23,340 4.2% 88.2%

Nuclear medicine 46% 496 2.2% 90.3%

Infectious disease 70% 4,763 2.5% 90.3%

Diagnostic radiology 29% 15,956 0.8% 92.0%

Cardiac surgery 59% 1,527 0.5% 92.5%

Family practice 85% 93,939 1.6% 91.6%

Podiatry 16% 3,305 2.3% 91.0%

Pathology 39% 6,037 2.1% 91.2%

Vascular surgery 68% 3,008 0.5% 92.8%

Specialty

Total Billing 

Relationships 

Captured

Cost Range Composition for EPs of ea

Specialty-Adjusted per Capita Cost 

 (rows sum to 100% )

Percent Billing 

Relationships 

Captured
Critical care (intensivists) 75% 2,888 1.7% 91.7%

Pediatric medicine 73% 8,565 1.2% 92.2%

Interventional radiology 37% 820 0.7% 92.9%

Oral surgery (dentists only) 14% 459 1.5% 92.4%

Plastic and Reconstructive surgery 32% 1,985 3.4% 90.8%

Psychiatry 35% 13,233 5.9% 88.4%

Peripheral vascular disease 69% 90 0.0% 94.4%

Orthopedic surgery 76% 21,092 3.5% 91.0%

Neuropsychiatry 36% 75 4.0% 90.7%

Pulmonary disease 78% 10,854 3.0% 91.7%

Preventive medicine 76% 532 3.2% 91.5%

Anesthesiology 30% 14,040 2.1% 92.7%

Maxillofacial surgery 12% 226 0.9% 94.7%

Certified nurse midwife 72% 1,953 1.9% 93.8%

Physical therapist 16% 7,479 3.1% 92.6%

Cardiology 77% 34,305 3.7% 92.3%

Registered Dietician/Nutrition Professional 63% 2,083 2.2% 93.9%

Obstetrics/gynecology 54% 21,049 7.8% 88.3%

Ophthalmology 53% 12,951 12.1% 84.0%

Optometry 13% 4,778 11.2% 85.3%

Occupational therapist 28% 1,625 3.6% 93.0%

Urology 82% 10,255 4.3% 92.8%

Neurology 74% 13,169 4.7% 92.4%

Rheumatology 85% 4,774 3.7% 93.5%

Nephrology 82% 8,988 10.1% 87.2%

Otolaryngology 73% 8,250 13.2% 84.1%

Gastroenterology 75% 12,375 4.2% 93.1%

Sports Medicine 96% 305 2.6% 94.8%

Cardiac Electrophysiology 85% 1,231 1.1% 96.5%

Allergy/immunology 48% 2,087 5.3% 92.3%

Dermatology 74% 9,874 20.6% 77.3%

Audiologist 48% 3,641 12.9% 85.0%

Mass Immunization Roster Biller 0% 153 2.6% 95.4%

Endocrinology 88% 5,993 7.4% 90.7%

Hand surgery 76% 1,292 3.3% 95.4%

Addiction medicine 48% 85 4.7% 94.1%

Anesthesiologist Assistant 29% 424 12.3% 87.5%

Total 697,504

*Note: green indicates that a specialty had proportionally more high cost billing relationships when evaluating 

evaluating straight per capita cost than when evaluating the specialty-weighted per capita cost.
 Each EP can have multiple billing relationships, as can each TIN.

eficiaries - Specialty Weighted by Percent of TIN Charges

High Total Low Medium High Low

26.4% 100.0% 0.3% 10.0% -10.3% 0.0%

18.8% 100.0% 0.2% 6.9% -7.1% 0.3%

17.5% 100.0% 0.0% 0.0% 0.0% 0.0%

17.0% 100.0% 0.1% 1.0% -1.1% 0.0%

16.6% 100.0% 1.9% 2.6% -4.4% 0.4%

16.2% 100.0% 0.0% 1.2% -1.2% 0.0%

15.3% 100.0% 0.1% 5.0% -5.1% 0.0%

15.2% 100.0% 0.0% 5.4% -5.4% 0.1%

15.1% 100.0% 0.2% 0.2% -0.4% 0.1%

13.6% 100.0% -0.1% -1.2% 1.3% 0.2%

12.6% 100.0% -0.1% 0.1% 0.0% 0.1%

11.3% 100.0% -0.3% 0.2% 0.1% 6.8%

11.0% 100.0% -0.5% 0.5% 0.0% 0.1%

10.5% 100.0% 0.0% -1.2% 1.2% 0.0%

10.4% 100.0% -0.1% 0.5% -0.3% 11.0%

9.9% 100.0% -0.4% 0.4% 0.0% 0.5%

9.7% 100.0% -0.7% 0.9% -0.2% 2.0%

9.4% 100.0% 0.4% 0.4% -0.9% 0.1%

9.4% 100.0% 0.3% 0.1% -0.3% 0.7%

9.4% 100.0% -3.1% 3.1% 0.0% 0.0%

8.9% 100.0% -0.1% 0.7% -0.6% 1.1%

8.3% 100.0% -0.3% 0.5% -0.2% 0.7%

8.2% 100.0% -1.2% -0.1% 1.3% 1.7%

8.0% 100.0% 0.1% 0.0% -0.2% 5.0%

8.0% 100.0% 0.2% 0.2% -0.4% 0.6%

7.9% 100.0% -0.6% 0.9% -0.3% 0.1%

7.8% 100.0% -0.1% 0.3% -0.2% 0.0%

7.8% 100.0% -0.2% 0.6% -0.4% 0.2%

7.7% 100.0% 0.2% -0.7% 0.5% 0.1%

7.6% 100.0% 0.0% 1.6% -1.6% 0.1%

7.6% 100.0% -0.5% 0.9% -0.4% 3.7%

7.5% 100.0% 0.0% 0.2% -0.2% 0.0%

7.2% 100.0% 0.0% 0.3% -0.3% 0.5%

7.2% 100.0% -0.1% 0.6% -0.6% 0.5%

7.0% 100.0% -0.1% 0.5% -0.4% 0.0%

6.8% 100.0% -0.3% 0.1% 0.2% 5.8%

6.7% 100.0% -0.1% 0.3% -0.2% 0.3%

6.7% 100.0% 0.3% 0.0% -0.3% 0.5%

6.7% 100.0% -0.2% 0.9% -0.7% 0.1%

Difference in Percentage Points of Cost Range 

Composition for EPs of each Specialty

(EP-Adjusted minus Specialty-Adjusted)

Specialty Composition of Each Cos

Specialty-Adjusted per Capita C

 (columns sum to 100

omposition for EPs of each Specialty

Adjusted per Capita Cost Analysis

 (rows sum to 100% )
6.6% 100.0% 0.0% 0.2% -0.2% 0.2%

6.5% 100.0% 0.0% 0.3% -0.3% 0.4%

6.3% 100.0% 0.0% 0.1% -0.1% 0.0%

6.1% 100.0% 0.0% 0.0% 0.0% 0.0%

5.8% 100.0% 0.8% -0.4% -0.4% 0.3%

5.7% 100.0% -0.9% 0.4% 0.5% 3.0%

5.6% 100.0% 0.0% 0.0% 0.0% 0.0%

5.5% 100.0% -0.5% 0.5% 0.0% 2.9%

5.3% 100.0% 0.0% 0.0% 0.0% 0.0%

5.3% 100.0% 0.3% 0.3% -0.6% 1.2%

5.3% 100.0% -0.2% -0.2% 0.4% 0.1%

5.2% 100.0% -0.5% 0.8% -0.3% 1.1%

4.4% 100.0% 0.0% 0.0% 0.0% 0.0%

4.2% 100.0% 0.0% 0.2% -0.2% 0.1%

4.2% 100.0% -0.3% 0.2% 0.1% 0.9%

4.0% 100.0% 0.7% -0.1% -0.6% 4.9%

4.0% 100.0% -0.1% 0.0% 0.1% 0.2%

3.9% 100.0% -0.1% 0.8% -0.7% 6.3%

3.8% 100.0% 5.5% -3.2% -2.3% 6.0%

3.5% 100.0% 3.8% -2.8% -1.0% 2.0%

3.4% 100.0% 0.0% 0.0% 0.0% 0.2%

2.9% 100.0% -0.4% 0.5% 0.0% 1.7%

2.9% 100.0% 0.3% 0.0% -0.4% 2.4%

2.8% 100.0% 0.2% 0.0% -0.2% 0.7%

2.7% 100.0% -2.4% 2.1% 0.3% 3.5%

2.7% 100.0% 0.2% 0.1% -0.4% 4.2%

2.7% 100.0% 0.2% 0.2% -0.4% 2.0%

2.6% 100.0% 0.0% 0.0% 0.0% 0.0%

2.4% 100.0% 0.8% -0.8% 0.0% 0.0%

2.3% 100.0% 0.0% 0.0% 0.0% 0.4%

2.2% 100.0% 10.0% -9.2% -0.8% 7.8%

2.1% 100.0% 0.1% 0.3% -0.5% 1.8%

2.0% 100.0% -0.7% 0.0% 0.7% 0.0%

1.9% 100.0% 1.8% -1.6% -0.2% 1.7%

1.3% 100.0% -0.2% 0.2% 0.0% 0.2%

1.2% 100.0% 0.0% 0.0% 0.0% 0.0%

0.2% 100.0% 0.0% 0.0% 0.0% 0.2%

100.0%

nships when evaluating straight per capita cost than when evaluating the specialty-weighted per capita cost. Yellow indicates that a sp

pita cost.
Medium High Low Medium High

0.4% 1.9% 0.0% 0.1% -0.7%

1.3% 3.6% 0.1% 0.1% -1.2%

0.0% 0.0% 0.0% 0.0% 0.0%

0.1% 0.3% 0.0% 0.0% 0.0%

0.5% 1.2% 0.2% 0.0% -0.3%

0.0% 0.1% 0.0% 0.0% 0.0%

0.1% 0.3% 0.0% 0.0% -0.1%

0.1% 0.3% 0.0% 0.0% -0.1%

0.4% 0.7% 0.0% 0.0% 0.0%

0.5% 1.0% 0.0% 0.0% 0.2%

0.1% 0.2% 0.0% 0.0% 0.0%

15.7% 23.8% -1.4% 0.0% 1.5%

0.2% 0.3% 0.0% 0.0% 0.0%

0.0% 0.1% 0.0% 0.0% 0.0%

7.1% 10.3% -0.7% 0.0% 0.2%

0.8% 1.1% -0.1% 0.0% 0.1%

1.1% 1.5% -0.3% 0.0% 0.1%

0.1% 0.1% 0.0% 0.0% 0.0%

0.4% 0.6% 0.0% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0%

2.5% 2.9% -0.1% 0.0% 0.0%

0.7% 0.7% -0.1% 0.0% 0.0%

0.6% 0.7% -0.3% 0.0% 0.2%

6.0% 6.4% 0.0% 0.0% 0.2%

2.4% 2.5% 0.1% 0.0% 0.0%

0.1% 0.1% 0.0% 0.0% 0.0%

0.3% 0.3% 0.0% 0.0% 0.0%

0.3% 0.3% 0.0% 0.0% 0.0%

0.1% 0.1% 0.0% 0.0% 0.0%

0.1% 0.1% 0.0% 0.0% 0.0%

3.3% 3.4% -0.5% 0.0% 0.0%

0.1% 0.1% 0.0% 0.0% 0.0%

0.7% 0.7% 0.0% 0.0% 0.0%

2.4% 2.2% -0.1% 0.0% -0.1%

0.2% 0.2% 0.0% 0.0% 0.0%

13.9% 12.1% -1.2% 0.0% 1.0%

0.5% 0.4% 0.0% 0.0% 0.0%

0.9% 0.8% 0.0% 0.0% 0.0%

0.5% 0.4% 0.0% 0.0% 0.0%

cialty Composition of Each Cost Range of TINs

pecialty-Adjusted per Capita Cost Analysis

 (columns sum to 100% )

Difference in Percentage Points of Specialty 

Composition for each Cost Range of TINs

(EP-Adjusted minus Specialty-Adjusetd)
0.4% 0.4% 0.0% 0.0% 0.0%

1.3% 1.1% 0.0% 0.0% 0.0%

0.1% 0.1% 0.0% 0.0% 0.0%

0.1% 0.1% 0.0% 0.0% 0.0%

0.3% 0.2% 0.0% 0.0% 0.0%

1.9% 1.4% -0.6% 0.0% 0.2%

0.0% 0.0% 0.0% 0.0% 0.0%

3.1% 2.2% -0.5% 0.0% 0.1%

0.0% 0.0% 0.0% 0.0% 0.0%

1.6% 1.1% 0.1% 0.0% -0.1%

0.1% 0.1% 0.0% 0.0% 0.0%

2.1% 1.4% -0.3% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0%

0.3% 0.2% 0.0% 0.0% 0.0%

1.1% 0.6% -0.1% 0.0% 0.0%

5.1% 2.6% 0.7% 0.0% -0.3%

0.3% 0.2% 0.0% 0.0% 0.0%

3.0% 1.6% -0.3% 0.0% -0.2%

1.8% 0.9% 2.4% -0.1% -0.6%

0.7% 0.3% 0.6% 0.0% -0.1%

0.2% 0.1% 0.0% 0.0% 0.0%

1.5% 0.6% -0.2% 0.0% 0.0%

2.0% 0.7% 0.1% 0.0% -0.1%

0.7% 0.3% 0.0% 0.0% 0.0%

1.3% 0.5% -0.9% 0.0% 0.1%

1.1% 0.4% -0.1% 0.0% 0.0%

1.9% 0.6% 0.0% 0.0% -0.1%

0.0% 0.0% 0.0% 0.0% 0.0%

0.2% 0.1% 0.0% 0.0% 0.0%

0.3% 0.1% 0.0% 0.0% 0.0%

1.2% 0.4% 3.3% -0.2% -0.1%

0.5% 0.1% -0.1% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0%

0.9% 0.2% 0.3% 0.0% 0.0%

0.2% 0.0% 0.0% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0%

0.1% 0.0% 0.0% 0.0% 0.0%

100.0% 100.0% 0.0% 0.0% 0.0%

ost. Yellow indicates that a specialty had proportionally fewer high cost billing relationships when