HCISMod Report,,,,,,,,,
MEDICARE,,,,,,,,,
16.1.2 National - Summary by Outlier Claims for Outlier Visits - PPS,,,,,,,,,
Year: 2009,,,,,,,,,
( Denials Excluded / SCIC Included ),,,,,,,,,
"Thursday, March 10, 2011",,,,,,,,,
Paid HIPPS,Paid HHRG, Skilled Nursing , Physical Therapy , Occupational Therapy , Speech Pathology , Medical Social Services , Home Health Aide ,Other,Total
1AFK,C1F1S1," 45,673.00 ", 861.00 , 104.00 , 13.00 , 419.00 ," 10,387.00 ",0,57457
1AFL,C1F1S2," 1,016.00 ", 178.00 , 21.00 , -   , 5.00 , 437.00 ,0,1657
1AFM,C1F1S3," 1,805.00 ", 380.00 , 36.00 , 3.00 , 42.00 , 877.00 ,0,3143
1AGK,C1F2S1," 31,743.00 "," 1,527.00 ", 219.00 , 10.00 , 420.00 ," 18,823.00 ",0,52742
1AGL,C1F2S2," 1,292.00 ", 338.00 , 42.00 , 4.00 , 38.00 ," 1,413.00 ",0,3127
1AGM,C1F2S3," 4,186.00 "," 1,003.00 ", 154.00 , 10.00 , 80.00 ," 2,606.00 ",0,8039
1AHK,C1F3S1," 8,426.00 ", 409.00 , 35.00 , 4.00 , 78.00 ," 6,459.00 ",0,15411
1AHL,C1F3S2, 248.00 , 60.00 , 7.00 , -   , 11.00 , 413.00 ,0,739
1AHM,C1F3S3," 1,412.00 ", 358.00 , 49.00 , 2.00 , 29.00 ," 1,687.00 ",0,3537
1BFK,C2F1S1," 118,284.00 "," 1,649.00 ", 206.00 , 49.00 , 635.00 ," 16,073.00 ",0,136896
1BFL,C2F1S2," 2,674.00 ", 346.00 , 79.00 , 1.00 , 73.00 , 719.00 ,0,3892
1BFM,C2F1S3," 4,373.00 ", 780.00 , 96.00 , 18.00 , 65.00 ," 1,260.00 ",0,6592
1BGK,C2F1S1," 121,564.00 "," 3,901.00 ", 438.00 , 64.00 , 901.00 ," 52,314.00 ",0,179182
1BGL,C2F1S2," 3,872.00 ", 804.00 , 60.00 , 13.00 , 61.00 ," 3,103.00 ",0,7913
1BGM,C2F1S3," 9,926.00 "," 2,016.00 ", 256.00 , 11.00 , 183.00 ," 6,317.00 ",0,18709
1BHK,C2F3S1," 32,090.00 "," 1,270.00 ", 162.00 , 47.00 , 275.00 ," 23,425.00 ",0,57269
1BHL,C2F3S2," 1,428.00 ", 227.00 , 64.00 , 2.00 , 12.00 ," 1,067.00 ",0,2800
1BHM,C2F3S3," 3,834.00 ", 749.00 , 142.00 , 4.00 , 49.00 ," 2,823.00 ",0,7601
1CFK,C3F1S1," 871,129.00 "," 5,839.00 ", 760.00 , 87.00 ," 1,987.00 "," 39,613.00 ",0,919415
1CFL,C3F1S2," 10,793.00 ", 979.00 , 132.00 , 25.00 , 81.00 , 987.00 ,0,12997
1CFM,C3F1S3," 24,981.00 "," 2,866.00 ", 425.00 , 36.00 , 159.00 ," 2,454.00 ",0,30921
1CGK,C3F2S1," 1,391,427.00 "," 17,850.00 "," 1,877.00 ", 149.00 ," 3,766.00 "," 188,991.00 ",0,1604060
1CGL,C3F2S2," 26,513.00 "," 2,812.00 ", 234.00 , 30.00 , 190.00 ," 5,366.00 ",0,35145
1CGM,C3F2S3," 74,798.00 "," 9,307.00 ", 896.00 , 133.00 , 555.00 ," 14,118.00 ",0,99807
1CHK,C3F3S1," 444,571.00 "," 7,645.00 "," 1,028.00 ", 170.00 ," 1,528.00 "," 122,211.00 ",0,577153
1CHL,C3F3S2," 16,165.00 "," 1,642.00 ", 293.00 , 30.00 , 184.00 ," 4,603.00 ",0,22917
1CHM,C3F3S3," 39,003.00 "," 4,612.00 ", 593.00 , 68.00 , 263.00 ," 10,019.00 ",0,54558
2AFK,C1F1S1," 1,002.00 ", 278.00 , 46.00 , -   , 5.00 , 242.00 ,0,1573
2AFL,C1F1S2, 536.00 , 157.00 , 42.00 , 7.00 , 2.00 , 111.00 ,0,855
2AFM,C1F1S3, 291.00 , 130.00 , 18.00 , -   , 4.00 , 104.00 ,0,547
2AGK,C1F2S1," 3,089.00 ", 954.00 , 108.00 , -   , 20.00 ," 1,730.00 ",0,5901
2AGL,C1F2S2," 1,086.00 ", 443.00 , 104.00 , 25.00 , 14.00 , 954.00 ,0,2626
2AGM,C1F2S3, 901.00 , 291.00 , 107.00 , -   , 2.00 , 582.00 ,0,1883
2AHK,C1F3S1," 1,286.00 ", 414.00 , 27.00 , 2.00 , 10.00 , 633.00 ,0,2372
2AHL,C1F3S2, 908.00 , 436.00 , 70.00 , -   , 16.00 , 845.00 ,0,2275
2AHM,C1F3S3, 540.00 , 177.00 , 48.00 , 6.00 , 3.00 , 291.00 ,0,1065
2BFK,C2F1S1," 4,550.00 ", 980.00 , 121.00 , 28.00 , 31.00 , 458.00 ,0,6168
2BFL,C2F1S2," 1,488.00 ", 490.00 , 101.00 , 33.00 , 33.00 , 398.00 ,0,2543
2BFM,C2F1S3," 1,347.00 ", 339.00 , 121.00 , 2.00 , 14.00 , 288.00 ,0,2111
2BGK,C2F2S1," 11,846.00 "," 3,007.00 ", 452.00 , 24.00 , 76.00 ," 4,187.00 ",0,19592
2BGL,C2F2S2," 5,671.00 "," 1,626.00 ", 309.00 , 25.00 , 60.00 ," 2,633.00 ",0,10324
2BGM,C2F2S3," 3,013.00 "," 1,083.00 ", 350.00 , 47.00 , 27.00 ," 1,425.00 ",0,5945
2BHK,C2F3S1," 5,385.00 "," 1,438.00 ", 243.00 , 26.00 , 62.00 ," 2,760.00 ",0,9914
2BHL,C2F3S2," 2,829.00 ", 948.00 , 176.00 , -   , 20.00 ," 2,059.00 ",0,6032
2BHM,C2F3S3," 1,836.00 ", 725.00 , 222.00 , 32.00 , 27.00 ," 1,549.00 ",0,4391
2CFK,C3F1S1," 23,965.00 "," 3,433.00 ", 314.00 , 36.00 , 46.00 ," 1,391.00 ",0,29185
2CFL,C3F1S2," 12,754.00 "," 1,984.00 ", 262.00 , 26.00 , 44.00 , 917.00 ,0,15987
2CFM,C3F1S3," 7,378.00 "," 1,126.00 ", 295.00 , 11.00 , 13.00 , 501.00 ,0,9324
2CGK,C3F2S1," 96,388.00 "," 13,742.00 "," 1,375.00 ", 160.00 , 252.00 ," 15,079.00 ",0,126996
2CGL,C3F2S2," 38,427.00 "," 6,119.00 "," 1,070.00 ", 91.00 , 124.00 ," 5,625.00 ",0,51456
2CGM,C3F2S3," 24,561.00 "," 4,121.00 "," 1,192.00 ", 142.00 , 101.00 ," 5,544.00 ",0,35661
2CHK,C3F3S1," 56,597.00 "," 9,070.00 "," 1,147.00 ", 137.00 , 205.00 ," 14,185.00 ",0,81341
2CHL,C3F3S2," 33,903.00 "," 5,427.00 "," 1,023.00 ", 103.00 , 171.00 ," 8,284.00 ",0,48911
2CHM,C3F3S3," 19,341.00 "," 3,636.00 ", 909.00 , 73.00 , 107.00 ," 5,620.00 ",0,29686
3AFK,C1F1S1," 66,370.00 ", 565.00 , 79.00 , 10.00 , 212.00 ," 22,037.00 ",0,89273
3AFL,C1F1S2, 584.00 , 78.00 , 6.00 , -   , 5.00 , 295.00 ,0,968
3AFM,C1F1S3," 2,156.00 ", 311.00 , 62.00 , 8.00 , 17.00 , 599.00 ,0,3153
3AGK,C1F2S1," 105,653.00 "," 1,339.00 ", 140.00 , 15.00 , 388.00 ," 67,619.00 ",0,175154
3AGL,C1F2S2," 1,301.00 ", 162.00 , 24.00 , -   , 7.00 , 934.00 ,0,2428
3AGM,C1F2S3," 4,743.00 ", 905.00 , 123.00 , 18.00 , 25.00 ," 3,295.00 ",0,9109
3AHK,C1F3S1," 36,465.00 ", 531.00 , 73.00 , 11.00 , 124.00 ," 31,537.00 ",0,68741
3AHL,C1F3S2, 687.00 , 77.00 , 29.00 , 20.00 , 4.00 , 617.00 ,0,1434
3AHM,C1F3S3," 1,288.00 ", 256.00 , 17.00 , 10.00 , 2.00 ," 1,214.00 ",0,2787
3BFK,C2F1S1," 1,964,439.00 "," 5,340.00 ", 459.00 , 71.00 ," 2,015.00 "," 103,322.00 ",0,2075646
3BFL,C2F1S2," 8,038.00 ", 530.00 , 37.00 , 12.00 , 8.00 , 657.00 ,0,9282
3BFM,C2F1S3," 24,696.00 "," 1,888.00 ", 219.00 , 41.00 , 36.00 ," 1,326.00 ",0,28206
3BGK,C2F2S1," 4,302,316.00 "," 16,992.00 "," 1,533.00 ", 182.00 ," 4,975.00 "," 601,637.00 ",0,4927635
3BGL,C2F2S2," 25,261.00 "," 1,696.00 ", 165.00 , 15.00 , 64.00 ," 3,714.00 ",0,30915
3BGM,C2F2S3," 77,700.00 "," 6,375.00 ", 540.00 , 66.00 , 157.00 ," 11,730.00 ",0,96568
3BHK,C2F3S1," 837,227.00 "," 4,288.00 ", 475.00 , 71.00 , 920.00 ," 171,076.00 ",0,1014057
3BHL,C2F3S2," 8,081.00 ", 580.00 , 48.00 , 8.00 , 14.00 ," 1,203.00 ",0,9934
3BHM,C2F3S3," 24,249.00 "," 2,132.00 ", 230.00 , 34.00 , 48.00 ," 3,695.00 ",0,30388
3CFK,C3F1S1," 1,971,080.00 "," 5,597.00 ", 578.00 , 73.00 ," 1,991.00 "," 97,410.00 ",0,2076729
3CFL,C3F1S2," 11,193.00 ", 736.00 , 96.00 , 31.00 , 56.00 ," 1,188.00 ",0,13300
3CFM,C3F1S3," 25,293.00 "," 2,075.00 ", 342.00 , 27.00 , 58.00 ," 1,702.00 ",0,29497
3CGK,C3F2S1," 5,280,741.00 "," 19,212.00 "," 2,014.00 ", 234.00 ," 4,969.00 "," 708,337.00 ",0,6015507
3CGL,C3F2S2," 34,686.00 "," 2,323.00 ", 207.00 , 39.00 , 60.00 ," 4,636.00 ",0,41951
3CGM,C3F2S3," 100,473.00 "," 8,048.00 "," 1,023.00 ", 129.00 , 210.00 ," 14,521.00 ",0,124404
3CHK,C3F3S1," 2,142,522.00 "," 9,647.00 "," 1,776.00 ", 339.00 ," 2,836.00 "," 562,160.00 ",0,2719280
3CHL,C3F3S2," 21,501.00 "," 1,516.00 ", 338.00 , 74.00 , 56.00 ," 6,230.00 ",0,29715
3CHM,C3F3S3," 69,930.00 "," 5,927.00 ", 964.00 , 115.00 , 251.00 ," 15,438.00 ",0,92625
4AFK,C1F1S1, 937.00 , 253.00 , 27.00 , 11.00 , 3.00 , 228.00 ,0,1459
4AFL,C1F1S2, 671.00 , 207.00 , 29.00 , 5.00 , 1.00 , 175.00 ,0,1088
4AFM,C1F1S3, 125.00 , 48.00 , 7.00 , 12.00 , -   , 84.00 ,0,276
4AGK,C1F2S1," 4,971.00 "," 1,296.00 ", 124.00 , 14.00 , 6.00 ," 2,267.00 ",0,8678
4AGL,C1F2S2," 2,101.00 ", 640.00 , 122.00 , 12.00 , 7.00 ," 1,143.00 ",0,4025
4AGM,C1F2S3," 1,169.00 ", 311.00 , 82.00 , 18.00 , 13.00 , 641.00 ,0,2234
4AHK,C1F3S1, 896.00 , 237.00 , 3.00 , -   , 5.00 , 511.00 ,0,1652
4AHL,C1F3S2, 525.00 , 105.00 , 42.00 , -   , 1.00 , 78.00 ,0,751
4AHM,C1F3S3, 205.00 , 60.00 , 6.00 , -   , -   , 147.00 ,0,418
4BFK,C2F1S1," 10,641.00 "," 1,501.00 ", 157.00 , 14.00 , 3.00 ," 1,183.00 ",0,13499
4BFL,C2F1S2," 6,311.00 ", 817.00 , 163.00 , 18.00 , 2.00 , 441.00 ,0,7752
4BFM,C2F1S3," 2,985.00 ", 439.00 , 146.00 , -   , 1.00 , 334.00 ,0,3905
4BGK,C2F2S1," 55,838.00 "," 7,637.00 ", 784.00 , 68.00 , 54.00 ," 12,577.00 ",0,76958
4BGL,C2F2S2," 22,569.00 "," 3,732.00 ", 573.00 , 55.00 , 46.00 ," 6,585.00 ",0,33560
4BGM,C2F2S3," 11,023.00 "," 1,949.00 ", 451.00 , 14.00 , 12.00 ," 3,415.00 ",0,16864
4BHK,C2F3S1," 7,309.00 "," 1,212.00 ", 140.00 , -   , 22.00 ," 2,577.00 ",0,11260
4BHL,C2F3S2," 5,038.00 ", 939.00 , 91.00 , 3.00 , 2.00 ," 1,700.00 ",0,7773
4BHM,C2F3S3," 2,232.00 ", 524.00 , 88.00 , -   , 2.00 ," 1,343.00 ",0,4189
4CFK,C3F1S1," 84,296.00 "," 9,621.00 ", 866.00 , 77.00 , 40.00 ," 4,956.00 ",0,99856
Totals:,,,,,,,,,
,Non-LUPA," 22,822,785.00 "," 505,424.00 "," 94,739.00 "," 16,826.00 "," 36,176.00 "," 3,420,508.00 ",0,26896458
,LUPA, -   , -   , -   , -   , -   , -   ,0,0
,Grid," 22,822,785.00 "," 505,424.00 "," 94,739.00 "," 16,826.00 "," 36,176.00 "," 3,420,508.00 ",0,26896458