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

Table 4. EP Specialty Composition of Each Cost Range for TINs with 1+ EPs and 20+ Beneficiaries - Specialty Weighted by Percent of TIN Charges

LowMedium 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% 111,2581.6% 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 rehabilitation57% 5,593 2.5% 87.5% General practice 64% 8,283 6.4% 83.9% Osteopathic manipulative therapy57% 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 Management58% 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 each Specialty

Specialty-Adjusted per Capita Cost Analysis

(rows sum to 100%) Percent Billing Relationships CapturedCritical 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 surgery32% 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% 12,95112.1%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 straight per capita cost than when evaluating the specialty-weighted per capita cost. Yellow indicates that a specialty had proportionally fewer high cost billing relationships when evaluating straight per capita cost than when evaluating the specialty-weighted per capita cost.Note: Billing relationships are defined as an instance of an EP billing under a given TIN. Each EP can have multiple billing relationships, as can each TIN.

Table 4. EP Specialty Composition of Each Cost Range for TINs with 1+ EPs and 20+ Beneficiaries - 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 Cost Range of TINs Specialty-Adjusted per Capita Cost Analysis (columns sum to 100%) Cost Range Composition for EPs of each Specialty 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%

*Note: green indicates that a specialty had proportionally more high cost billing relationships when evaluating straight per capita cost than when evaluating the specialty-weighted per capita cost. Yellow indicates that a specialty had proportionally fewer high cost billing relationships when evaluating straight per capita cost than when evaluating the specialty-weighted per capita 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% Specialty Composition of Each Cost Range of TINs Specialty-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%

*Note: green indicates that a specialty had proportionally more high cost billing relationships when evaluating straight per capita cost than when evaluating the specialty-weighted per capita cost. Yellow indicates that a specialty had proportionally fewer high cost billing relationships when evaluating straight per capita cost than when evaluating the specialty-weighted per capita cost.