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 6. EP Specialty Composition of Each Cost Range for TINs with 1+ EPs and 20+ Beneficiaries - Specialty Weight by Percent of TIN EPs

LowMedium Medical oncology 94% 3,709 0.2% 70.8% Hematology/oncology 90% 10,165 0.7% 77.0% Radiation oncology 56% 3,668 2.6% 78.3% Surgical oncology 81% 833 1.3% 80.6% Gynecologist/oncologist 76% 1,040 1.8% 80.1% Geriatric Psychiatry 44% 57 0.0% 82.5% Hematology 92% 1,101 0.6% 82.8% Unknown physician specialty 54% 167 0.6% 83.2% Geriatric medicine 93% 2,594 1.2% 83.2% Neurosurgery 67% 3,742 1.4% 84.2% Pain Management 56% 1,011 1.5% 85.6% Hospice and Palliative Care 81% 323 0.3% 87.9% Certified clinical nurse specialist 43% 1,275 2.9% 85.4% Internal medicine 83% 111,2581.5% 87.1% Nurse practitioner 71% 51,965 5.7% 83.7% Physical medicine and rehabilitation57% 5,593 2.3% 87.5% Osteopathic manipulative therapy57% 457 5.0% 84.9% Single or Multispecialty clinic or group practice 36% 3,145 5.7% 84.6% General practice 64% 8,283 6.2% 84.1% Clinical psychologist (billing indepedently)4% 32 12.5%78.1% Licensed clinical social worker 13% 4,726 8.7% 82.0% General surgery 63% 17,149 1.6% 89.3% Clinical psychologist 15% 4,594 3.7% 88.0% Interventional Pain Management58% 1,893 2.8% 89.0% Physician assistant 70% 42,108 3.6% 88.2% Thoracic surgery 62% 1,889 0.2% 91.8% Colorectal surgery 59% 957 3.1% 88.8% Neuropsychiatry 36% 75 4.0% 88.0% Certified Registered Nurse Anesthetists (CRNA) 31% 16,209 1.1% 90.9% Speech-language pathologist 28% 369 6.0% 86.2% Chiropractic 2% 843 3.3% 88.8% Nuclear medicine 46% 496 2.2% 90.1% Diagnostic radiology 29% 15,956 0.6% 91.8% Emergency medicine 37% 23,340 4.0% 88.5% Infectious disease 70% 4,763 2.4% 90.4% Cardiac surgery 59% 1,527 0.5% 92.3% Pathology 39% 6,037 2.4% 90.7% Family practice 85% 93,939 1.5% 91.6% Vascular surgery 68% 3,008 0.5% 92.7%

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 CapturedPodiatry 16% 3,305 2.2% 91.0%

Peripheral vascular disease 69% 90 0.0% 93.3% Critical care (intensivists) 75% 2,888 1.8% 91.6% Interventional radiology 37% 820 0.7% 92.7% Pediatric medicine 73% 8,565 1.2% 92.3% Oral surgery (dentists only) 14% 459 1.5% 92.4% Plastic and Reconstructive surgery32% 1,985 3.4% 90.6% Psychiatry 35% 13,233 5.5% 88.5% Orthopedic surgery 76% 21,092 3.4% 91.0% Anesthesiology 30% 14,040 2.0% 92.8% Pulmonary disease 78% 10,854 3.0% 92.0% Preventive medicine 76% 532 2.8% 92.1% Physical therapist 16% 7,479 2.9% 92.6% Maxillofacial surgery 12% 226 0.9% 94.7% Certified nurse midwife 72% 1,953 1.9% 93.8% Obstetrics/gynecology 54% 21,049 7.8% 88.2% Cardiology 77% 34,305 3.7% 92.3% Anesthesiologist Assistant 29% 424 12.3%83.7% Registered Dietician/Nutrition Professional 63% 2,083 2.4% 93.6% Optometry 13% 4,778 11.6%84.5% Occupational therapist 28% 1,625 3.5% 92.8% Ophthalmology 53% 12,95112.3%84.1% Urology 82% 10,255 4.3% 92.6% Neurology 74% 13,169 4.7% 92.3% Rheumatology 85% 4,774 3.6% 93.5% Gastroenterology 75% 12,375 4.1% 93.3% Sports Medicine 96% 305 2.6% 94.8% Nephrology 82% 8,988 10.8%86.5% Otolaryngology 73% 8,250 13.9%83.5% Cardiac Electrophysiology 85% 1,231 1.2% 96.3% Allergy/immunology 48% 2,087 5.4% 92.2% Dermatology 74% 9,874 24.7%73.2% Mass Immunization Roster Biller 0% 153 2.6% 95.4% Endocrinology 88% 5,993 7.4% 90.7% Audiologist 48% 3,641 13.9%84.3% Hand surgery 76% 1,292 3.2% 95.5% Addiction medicine 48% 85 4.7% 94.1%

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 6. EP Specialty Composition of Each Cost Range for TINs with 1+ EPs and 20+ Beneficiaries - Specialty Weight by Percent of TIN EPs

High Total Low Medium High Low 29.0%100.0% 0.3% 9.0% -9.4% 0.0% 22.3%100.0% 0.2% 7.6% -7.8% 0.3% 19.1%100.0% 1.5% 4.0% -5.5% 0.4% 18.1%100.0% 0.0% 1.7% -1.7% 0.0% 18.1%100.0% -0.1% 5.1% -5.0% 0.1% 17.5%100.0% 0.0% 0.0% 0.0% 0.0% 16.5%100.0% 0.0% 5.1% -5.1% 0.0% 16.2%100.0% 0.0% 0.6% -0.6% 0.0% 15.7%100.0% 0.2% 0.3% -0.5% 0.1% 14.4%100.0% -0.1% -0.9% 1.0% 0.2% 13.0%100.0% -0.1% 0.5% -0.4% 0.1% 11.8%100.0% 0.0% 0.0% 0.0% 0.0% 11.7%100.0% -0.3% 0.6% -0.3% 0.1% 11.4%100.0% -0.2% 0.1% 0.1% 6.3% 10.5%100.0% -0.2% 0.4% -0.3% 11.2% 10.2%100.0% -0.4% 0.4% -0.1% 0.5% 10.1%100.0% 0.7% 0.2% -0.9% 0.1% 9.7%100.0% 0.2% 0.3% -0.4% 0.7% 9.7%100.0% -0.7% 0.9% -0.3% 1.9% 9.4%100.0% -3.1% 3.1% 0.0% 0.0% 9.2%100.0% -0.9% 0.7% 0.2% 1.6% 9.0%100.0% 0.0% 0.6% -0.6% 1.1% 8.4%100.0% -0.2% 0.2% 0.0% 0.6% 8.2%100.0% -0.2% 0.7% -0.6% 0.2% 8.2%100.0% 0.1% 0.1% -0.2% 5.7% 8.0%100.0% -0.1% 0.3% -0.2% 0.0% 8.0%100.0% 0.0% 0.5% -0.5% 0.1% 8.0%100.0% 0.0% 0.0% 0.0% 0.0% 8.0%100.0% 0.0% 0.1% -0.1% 0.7% 7.9%100.0% 0.0% 0.0% 0.0% 0.1% 7.8%100.0% -0.5% 0.5% 0.0% 0.1% 7.7%100.0% 0.0% 0.2% -0.2% 0.0% 7.5%100.0% 0.0% 0.4% -0.4% 0.4% 7.5%100.0% -0.2% 0.4% -0.1% 3.5% 7.2%100.0% 0.1% 0.1% -0.2% 0.4% 7.1%100.0% 0.0% 0.2% -0.2% 0.0% 6.9%100.0% 0.4% 0.1% -0.6% 0.6% 6.9%100.0% -0.2% 0.1% 0.1% 5.4% 6.8%100.0% 0.0% 0.9% -0.9% 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%)6.8%100.0% 0.0% 0.4% -0.3% 0.3%

6.7%100.0% 0.0% 0.0% 0.0% 0.0% 6.6%100.0% -0.1% 0.2% -0.1% 0.2% 6.6%100.0% 0.0% 0.4% -0.4% 0.0% 6.5%100.0% 0.0% 0.1% -0.1% 0.4% 6.1%100.0% 0.0% 0.0% 0.0% 0.0% 6.0%100.0% 0.7% -0.3% -0.4% 0.3% 6.0%100.0% -0.5% 0.3% 0.2% 2.7% 5.6%100.0% -0.5% 0.6% -0.1% 2.7% 5.2%100.0% -0.4% 0.5% -0.1% 1.1% 5.1%100.0% 0.3% 0.0% -0.3% 1.2% 5.1%100.0% 0.0% -0.2% 0.2% 0.1% 4.4%100.0% -0.3% 0.2% 0.1% 0.8% 4.4%100.0% 0.0% 0.0% 0.0% 0.0% 4.3%100.0% 0.0% 0.3% -0.3% 0.1% 4.0%100.0% 0.0% 0.4% -0.4% 6.2% 4.0%100.0% 0.7% -0.1% -0.6% 4.8% 4.0%100.0% 0.0% 0.0% 0.0% 0.2% 4.0%100.0% -0.3% 0.3% 0.0% 0.2% 3.9%100.0% 3.0% -2.2% -0.8% 2.1% 3.7%100.0% -0.4% 0.2% 0.1% 0.2% 3.6%100.0% 5.3% -3.2% -2.1% 6.0% 3.1%100.0% -0.3% 0.6% -0.3% 1.6% 3.0%100.0% 0.4% 0.0% -0.3% 2.3% 2.9%100.0% 0.3% -0.1% -0.2% 0.7% 2.6%100.0% 0.3% 0.1% -0.3% 1.9% 2.6%100.0% 0.0% 0.0% 0.0% 0.0% 2.6%100.0% -1.8% 1.6% 0.2% 3.7% 2.6%100.0% -0.5% 0.7% -0.2% 4.3% 2.5%100.0% 0.5% -0.5% 0.0% 0.1% 2.3%100.0% -0.1% 0.0% 0.1% 0.4% 2.1%100.0% 8.5% -7.7% -0.7% 9.2% 2.0%100.0% -2.6% 2.6% 0.0% 0.0% 1.9%100.0% 1.7% -1.5% -0.2% 1.7% 1.8%100.0% -0.8% 0.8% 0.0% 1.9% 1.3%100.0% -0.5% 0.6% -0.1% 0.2% 1.2%100.0% 0.0% 0.0% 0.0% 0.0%

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% 2.0% 0.0% 0.1% -0.6% 1.3% 4.2% 0.1% 0.1% -1.3% 0.5% 1.3% 0.2% 0.0% -0.3% 0.1% 0.3% 0.0% 0.0% 0.0% 0.1% 0.3% 0.0% 0.0% -0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.3% 0.0% 0.0% -0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 0.3% 0.8% 0.0% 0.0% 0.0% 0.5% 1.0% 0.0% 0.0% 0.1% 0.1% 0.2% 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.2% 0.3% 0.0% 0.0% 0.0% 15.7% 23.5% -1.0% 0.0% 1.3% 7.1% 10.2% -0.7% 0.0% 0.2% 0.8% 1.1% -0.1% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.4% 0.6% 0.0% 0.0% 0.0% 1.1% 1.5% -0.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.6% 0.8% -0.2% 0.0% 0.1% 2.5% 2.9% -0.1% 0.0% 0.0% 0.7% 0.7% 0.0% 0.0% 0.0% 0.3% 0.3% 0.0% 0.0% 0.0% 6.0% 6.4% -0.1% 0.0% 0.2% 0.3% 0.3% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 2.4% 2.4% 0.0% 0.0% 0.1% 0.1% 0.1% 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% 2.4% 2.2% 0.0% 0.0% 0.0% 3.3% 3.2% -0.3% 0.0% 0.1% 0.7% 0.6% 0.0% 0.0% 0.0% 0.2% 0.2% 0.0% 0.0% 0.0% 0.9% 0.8% 0.1% 0.0% 0.0% 13.9% 12.0% -1.0% 0.0% 0.9% 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)0.5% 0.4% 0.0% 0.0% 0.0%

0.0% 0.0% 0.0% 0.0% 0.0% 0.4% 0.4% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 1.3% 1.0% 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% 1.5% -0.4% 0.0% 0.1% 3.1% 2.2% -0.5% 0.0% 0.1% 2.1% 1.3% -0.2% 0.0% 0.0% 1.6% 1.0% 0.1% 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 1.1% 0.6% -0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.3% 0.2% 0.0% 0.0% 0.0% 3.0% 1.6% -0.3% 0.0% -0.1% 5.1% 2.6% 0.7% 0.0% -0.2% 0.1% 0.0% 0.0% 0.0% 0.0% 0.3% 0.2% 0.0% 0.0% 0.0% 0.7% 0.3% 0.4% 0.0% -0.1% 0.2% 0.1% 0.0% 0.0% 0.0% 1.8% 0.9% 2.3% -0.1% -0.5% 1.5% 0.6% -0.2% 0.0% 0.0% 2.0% 0.7% 0.1% 0.0% 0.0% 0.7% 0.3% 0.0% 0.0% 0.0% 1.9% 0.6% 0.0% 0.0% -0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 1.3% 0.4% -0.7% 0.0% 0.1% 1.1% 0.4% -0.3% 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% 2.7% -0.1% -0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.9% 0.2% 0.3% 0.0% 0.0% 0.5% 0.1% -0.2% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 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.