HCISMod Report,,,,,,,,,,,, MEDICARE,,,,,,,,,,,, 16.1.3 National - Summary by Outlier Claims for Units of Service Totals - PPS,,,,,,,,,,,, Year: 2009,,,,,,,,,,,, ( Display All Units / 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 , Passthru DME , Passthru Orthotics & Prosthetics , Wound Care , Other Med/Surg Supplies , Other 1AFK,C1F1S1," 317,879.00 "," 34,098.00 ", 317.00 , 45.00 ," 1,496.00 "," 186,774.00 ", - , - ," 21,384.00 "," 30,118.00 ", - 1AFL,C1F1S2," 2,860.00 ", 511.00 , 69.00 , - , 21.00 ," 3,482.00 ", - , - , 95.00 ," 1,002.00 ", - 1AFM,C1F1S3," 329,734.00 "," 1,108.00 "," 101,603.00 ", 13.00 ," 87,134.00 "," 119,471.00 ", - , - , 793.00 , 886.00 , - 1AGK,C1F2S1," 140,508.00 "," 4,393.00 ", 693.00 , 32.00 ," 1,599.00 "," 473,787.00 ", - , - ," 24,292.00 "," 40,782.00 ", - 1AGL,C1F2S2," 3,502.00 ", 937.00 , 142.00 , 16.00 , 133.00 ," 12,539.00 ", - , - , 675.00 ," 1,067.00 ", - 1AGM,C1F2S3," 11,802.00 "," 2,899.00 ", 484.00 , 33.00 , 271.00 ," 18,792.00 ", - , - ," 3,627.00 "," 1,949.00 ", - 1AHK,C1F3S1," 26,544.00 "," 1,192.00 ", 97.00 , 12.00 , 260.00 ," 41,737.00 ", - , - ," 3,382.00 "," 6,606.00 ", - 1AHL,C1F3S2, 677.00 , 155.00 , 15.00 , - , 29.00 ," 3,906.00 ", - , - , 14.00 , 70.00 , - 1AHM,C1F3S3," 4,151.00 "," 1,063.00 ", 148.00 , 7.00 , 92.00 ," 13,263.00 ", - , - ," 3,500.00 ", 589.00 , - 1BFK,C2F1S1," 850,549.00 "," 4,929.00 ", 648.00 , 152.00 ," 2,394.00 "," 682,039.00 ", - , - ," 51,776.00 "," 81,765.00 ", - 1BFL,C2F1S2," 487,317.00 "," 60,999.00 ", 241.00 , 4.00 , 269.00 ," 105,407.00 ", - , - ," 2,050.00 "," 4,001.00 ", - 1BFM,C2F1S3," 11,260.00 "," 2,380.00 ", 293.00 , 54.00 , 253.00 ," 8,418.00 ", - , - ," 2,165.00 "," 2,756.00 ", - 1BGK,C2F1S1," 547,903.00 "," 21,645.00 "," 1,363.00 ", 210.00 ," 14,752.00 "," 675,320.00 ", - , - ," 67,948.00 "," 71,504.00 ", - 1BGL,C2F1S2," 10,933.00 "," 2,382.00 ", 191.00 , 34.00 , 261.00 ," 24,332.00 ", - , - ," 2,144.00 "," 2,446.00 ", - 1BGM,C2F1S3," 26,849.00 "," 5,788.00 ", 760.00 , 42.00 , 620.00 ," 46,432.00 ", - , - ," 5,174.00 "," 4,333.00 ", - 1BHK,C2F3S1," 664,792.00 "," 100,046.00 ", 468.00 , 120.00 ," 23,958.00 "," 1,038,715.00 ", - , - ," 20,343.00 "," 28,190.00 ", - 1BHL,C2F3S2," 147,116.00 ", 717.00 ," 87,202.00 ", 8.00 , 56.00 ," 321,792.00 ", - , - , 293.00 , 606.00 , - 1BHM,C2F3S3," 10,748.00 "," 2,161.00 ", 511.00 , 17.00 , 172.00 ," 21,083.00 ", - , - ," 3,889.00 "," 1,648.00 ", - 1CFK,C3F1S1," 3,033,597.00 "," 16,903.00 "," 2,492.00 ", 267.00 ," 110,700.00 "," 639,980.00 ", - , - ," 275,362.00 "," 661,801.00 ", - 1CFL,C3F1S2," 28,717.00 "," 2,950.00 ", 449.00 , 70.00 , 263.00 ," 5,939.00 ", - , - ," 3,627.00 "," 6,946.00 ", - 1CFM,C3F1S3," 65,213.00 "," 8,958.00 "," 1,285.00 ", 89.00 , 558.00 ," 12,638.00 ", - , - ," 11,709.00 "," 15,285.00 ", - 1CGK,C3F2S1," 4,739,077.00 "," 104,147.00 "," 41,372.00 ", 527.00 ," 14,419.00 "," 2,658,361.00 ", - , - ," 439,337.00 "," 864,252.00 ", - 1CGL,C3F2S2," 72,896.00 "," 8,413.00 ", 676.00 , 86.00 , 692.00 ," 37,160.00 ", - , - ," 14,442.00 "," 16,454.00 ", - 1CGM,C3F2S3," 237,438.00 "," 32,406.00 "," 2,861.00 ", 402.00 ," 2,321.00 "," 95,703.00 ", - , - ," 35,394.00 "," 49,583.00 ", - 1CHK,C3F3S1," 2,208,196.00 "," 48,807.00 "," 3,154.00 ", 534.00 ," 6,273.00 "," 1,459,545.00 ", - , - ," 207,425.00 "," 437,654.00 ", - 1CHL,C3F3S2," 46,917.00 "," 5,206.00 ", 900.00 , 110.00 , 629.00 ," 31,078.00 ", - , - ," 8,269.00 "," 12,896.00 ", - 1CHM,C3F3S3," 128,157.00 "," 14,151.00 "," 1,889.00 ", 207.00 , 970.00 ," 71,109.00 ", - , - ," 18,646.00 "," 23,092.00 ", - 2AFK,C1F1S1," 2,329.00 ", 690.00 , 122.00 , - , 13.00 ," 1,089.00 ", - , - , 50.00 , 100.00 , - 2AFL,C1F1S2," 1,450.00 ", 437.00 , 78.00 , 27.00 , 8.00 , 282.00 , - , - , 373.00 , 118.00 , - 2AFM,C1F1S3, 634.00 , 284.00 , 53.00 , - , 16.00 , 222.00 , - , - , 47.00 , 31.00 , - 2AGK,C1F2S1," 7,250.00 "," 2,736.00 ", 311.00 , - , 77.00 ," 6,536.00 ", - , - ," 1,120.00 "," 1,864.00 ", - 2AGL,C1F2S2," 307,037.00 "," 43,201.00 "," 21,322.00 ", 42.00 ," 11,554.00 "," 217,591.00 ", - , - , 750.00 , 164.00 , - 2AGM,C1F2S3," 2,865.00 ", 733.00 , 247.00 , - , 7.00 ," 1,390.00 ", - , - ," 1,025.00 ", 437.00 , - 2AHK,C1F3S1," 3,353.00 "," 1,207.00 ", 77.00 , 7.00 , 32.00 ," 2,644.00 ", - , - ," 1,030.00 ", 510.00 , - 2AHL,C1F3S2," 2,286.00 "," 1,171.00 ", 155.00 , - , 86.00 ," 3,948.00 ", - , - ," 1,340.00 ", 296.00 , - 2AHM,C1F3S3," 1,239.00 ", 520.00 , 150.00 , 12.00 , 12.00 ," 1,439.00 ", - , - , 60.00 , 25.00 , - 2BFK,C2F1S1," 10,163.00 "," 2,798.00 ", 326.00 , 85.00 , 113.00 ," 1,835.00 ", - , - , 81.00 ," 1,270.00 ", - 2BFL,C2F1S2," 4,202.00 "," 1,455.00 ", 294.00 , 117.00 , 122.00 ," 1,797.00 ", - , - , 71.00 ," 1,910.00 ", - 2BFM,C2F1S3," 2,952.00 ", 971.00 , 394.00 , 4.00 , 55.00 , 852.00 , - , - , 103.00 , 687.00 , - 2BGK,C2F2S1," 31,642.00 "," 8,617.00 "," 1,389.00 ", 93.00 , 296.00 ," 18,170.00 ", - , - ," 2,392.00 "," 2,262.00 ", - 2BGL,C2F2S2," 14,021.00 "," 4,595.00 ", 910.00 , 76.00 , 227.00 ," 13,664.00 ", - , - , 462.00 ," 1,307.00 ", - 2BGM,C2F2S3," 6,857.00 "," 2,906.00 ", 977.00 , 130.00 , 96.00 ," 4,980.00 ", - , - ," 1,302.00 "," 1,348.00 ", - 2BHK,C2F3S1," 15,068.00 "," 4,217.00 ", 746.00 , 98.00 , 234.00 ," 10,188.00 ", - , - ," 2,646.00 "," 2,606.00 ", - 2BHL,C2F3S2," 8,042.00 "," 2,892.00 ", 590.00 , - , 74.00 ," 9,633.00 ", - , - ," 2,081.00 "," 1,169.00 ", - 2BHM,C2F3S3," 5,148.00 "," 2,510.00 ", 851.00 , 96.00 , 90.00 ," 6,019.00 ", - , - ," 1,415.00 "," 2,537.00 ", - 2CFK,C3F1S1," 59,008.00 "," 9,925.00 ", 948.00 , 121.00 , 172.00 ," 4,688.00 ", - , - ," 1,942.00 "," 8,868.00 ", - 2CFL,C3F1S2," 29,086.00 "," 5,620.00 ", 776.00 , 77.00 , 142.00 ," 3,887.00 ", - , - ," 2,274.00 "," 3,682.00 ", - 2CFM,C3F1S3," 17,300.00 "," 3,150.00 ", 877.00 , 52.00 , 48.00 ," 1,356.00 ", - , - , 655.00 ," 2,383.00 ", - 2CGK,C3F2S1," 774,739.00 "," 189,465.00 "," 14,559.00 ", 481.00 ," 1,677.00 "," 467,027.00 ", - , - ," 10,359.00 "," 31,050.00 ", - 2CGL,C3F2S2," 103,454.00 "," 18,269.00 "," 3,228.00 ", 297.00 , 479.00 ," 22,246.00 ", - , - ," 14,998.00 "," 21,128.00 ", - 2CGM,C3F2S3," 60,109.00 "," 12,307.00 "," 3,376.00 ", 457.00 , 391.00 ," 21,744.00 ", - , - ," 6,559.00 "," 14,341.00 ", - 2CHK,C3F3S1," 151,311.00 "," 27,951.00 "," 3,429.00 ", 443.00 , 766.00 ," 64,902.00 ", - , - ," 8,928.00 "," 26,858.00 ", - 2CHL,C3F3S2," 93,690.00 "," 16,284.00 "," 3,091.00 ", 280.00 , 721.00 ," 38,647.00 ", - , - ," 9,792.00 "," 15,710.00 ", - 2CHM,C3F3S3," 49,091.00 "," 10,632.00 "," 2,664.00 ", 214.00 , 408.00 ," 24,473.00 ", - , - ," 6,849.00 "," 9,725.00 ", - 3AFK,C1F1S1," 747,488.00 "," 1,757.00 ", 277.00 , 22.00 ," 35,179.00 "," 1,679,838.00 ", - , - ," 8,631.00 "," 21,680.00 ", - 3AFL,C1F1S2," 1,444.00 ", 241.00 , 24.00 , - , 18.00 ," 1,498.00 ", - , - , 423.00 , 123.00 , - 3AFM,C1F1S3," 8,423.00 "," 1,017.00 ", 161.00 , 32.00 , 52.00 ," 2,870.00 ", - , - , 296.00 , 302.00 , - 3AGK,C1F2S1," 462,589.00 "," 14,482.00 ", 469.00 , 50.00 ," 24,344.00 "," 897,010.00 ", - , - ," 12,878.00 "," 35,886.00 ", - 3AGL,C1F2S2," 2,980.00 ", 416.00 , 75.00 , - , 24.00 ," 5,903.00 ", - , - , 387.00 , 186.00 , - 3AGM,C1F2S3," 12,327.00 "," 2,730.00 ", 412.00 , 55.00 , 93.00 ," 15,482.00 ", - , - ," 3,482.00 "," 1,740.00 ", - 3AHK,C1F3S1," 91,901.00 "," 1,556.00 ", 187.00 , 33.00 , 419.00 ," 148,291.00 ", - , - ," 9,703.00 "," 21,298.00 ", - 3AHL,C1F3S2," 1,992.00 ", 191.00 , 86.00 , 47.00 , 15.00 ," 4,628.00 ", - , - , 3.00 , 350.00 , - 3AHM,C1F3S3," 3,409.00 ", 797.00 , 68.00 , 33.00 , 6.00 ," 6,524.00 ", - , - ," 1,484.00 ", 462.00 , - 3BFK,C2F1S1," 8,523,235.00 "," 35,363.00 "," 1,786.00 ", 209.00 ," 65,389.00 "," 1,923,099.00 ", - , - ," 52,656.00 "," 688,852.00 ", 4.00 3BFL,C2F1S2," 16,009.00 "," 1,489.00 ", 96.00 , 19.00 , 36.00 ," 3,637.00 ", - , - , 514.00 ," 3,796.00 ", - 3BFM,C2F1S3," 56,062.00 "," 5,588.00 ", 701.00 , 120.00 , 119.00 ," 5,039.00 ", - , - ," 4,492.00 "," 10,017.00 ", - 3BGK,C2F2S1," 11,396,941.00 "," 50,464.00 "," 4,165.00 ", 589.00 ," 24,289.00 "," 2,234,844.00 ", - , - ," 72,016.00 "," 922,836.00 ", - 3BGL,C2F2S2," 61,136.00 "," 5,090.00 ", 475.00 , 40.00 , 250.00 ," 16,230.00 ", - , - ," 1,024.00 "," 8,117.00 ", - 3BGM,C2F2S3," 686,862.00 "," 195,677.00 "," 1,572.00 ", 158.00 ," 13,045.00 "," 503,525.00 ", - , - ," 8,729.00 "," 45,837.00 ", - 3BHK,C2F3S1," 2,183,710.00 "," 14,026.00 "," 1,432.00 ", 225.00 ," 44,078.00 "," 765,467.00 ", - , 3.00 ," 30,906.00 "," 200,123.00 ", - 3BHL,C2F3S2," 20,692.00 "," 1,762.00 ", 154.00 , 30.00 , 42.00 ," 7,221.00 ", - , - , 236.00 ," 2,904.00 ", - 3BHM,C2F3S3," 57,769.00 "," 6,448.00 ", 702.00 , 116.00 , 172.00 ," 16,158.00 ", - , - ," 2,282.00 "," 8,747.00 ", - 3CFK,C3F1S1," 5,324,954.00 "," 15,099.00 "," 1,744.00 ", 222.00 ," 7,553.00 "," 348,210.00 ", - , - ," 225,487.00 "," 777,896.00 ", - 3CFL,C3F1S2," 26,203.00 "," 2,166.00 ", 271.00 , 82.00 , 221.00 ," 4,839.00 ", - , - ," 2,399.00 "," 6,388.00 ", - 3CFM,C3F1S3," 58,475.00 "," 6,023.00 ", 991.00 , 88.00 , 220.00 ," 7,944.00 ", - , - ," 7,995.00 "," 98,961.00 ", - 3CGK,C3F2S1," 18,948,200.00 "," 106,003.00 "," 5,626.00 ", 713.00 ," 19,047.00 "," 2,550,913.00 ", - , 5.00 ," 438,899.00 "," 1,678,244.00 ", - 3CGL,C3F2S2," 83,998.00 "," 6,968.00 ", 585.00 , 117.00 , 219.00 ," 22,060.00 ", - , - ," 3,915.00 "," 16,210.00 ", - 3CGM,C3F2S3," 258,955.00 "," 23,646.00 "," 3,154.00 ", 431.00 , 822.00 ," 58,261.00 ", - , - ," 15,031.00 "," 46,738.00 ", - 3CHK,C3F3S1," 9,180,760.00 "," 70,863.00 "," 5,704.00 "," 1,066.00 "," 10,879.00 "," 4,394,789.00 ", - , 57.00 ," 525,376.00 "," 2,518,869.00 ", - 3CHL,C3F3S2," 56,648.00 "," 4,706.00 "," 1,130.00 ", 257.00 , 241.00 ," 34,595.00 ", - , 31.00 ," 7,670.00 "," 11,980.00 ", - 3CHM,C3F3S3," 777,468.00 "," 91,944.00 "," 2,873.00 ", 415.00 , 943.00 ," 487,497.00 ", - , - ," 16,158.00 "," 254,975.00 ", - 4AFK,C1F1S1," 2,523.00 ", 749.00 , 78.00 , 44.00 , 10.00 , 799.00 , - , - , 30.00 , 121.00 , - 4AFL,C1F1S2," 1,508.00 ", 508.00 , 111.00 , 16.00 , 1.00 , 605.00 , - , - , 56.00 , 502.00 , - 4AFM,C1F1S3, 285.00 , 186.00 , 29.00 , 28.00 , - , 336.00 , - , - , 4.00 , 2.00 , - 4AGK,C1F2S1," 13,194.00 "," 3,945.00 ", 308.00 , 32.00 , 20.00 ," 7,907.00 ", - , - , 642.00 ," 1,018.00 ", - 4AGL,C1F2S2," 6,054.00 "," 2,004.00 ", 366.00 , 42.00 , 23.00 ," 4,281.00 ", - , - , 546.00 , 153.00 , - 4AGM,C1F2S3," 2,683.00 ", 869.00 , 257.00 , 54.00 , 44.00 ," 2,085.00 ", - , - , 398.00 ," 1,136.00 ", - 4AHK,C1F3S1," 2,372.00 ", 678.00 , 9.00 , - , 20.00 ," 1,898.00 ", - , - , 135.00 , 31.00 , - 4AHL,C1F3S2," 1,613.00 ", 364.00 , 125.00 , - , 4.00 , 295.00 , - , - , 7.00 , 385.00 , - 4AHM,C1F3S3," 1,127.00 ", 183.00 , 24.00 , - , - ," 1,230.00 ", - , - , 27.00 , - , - 4BFK,C2F1S1," 23,148.00 "," 4,059.00 ", 385.00 , 39.00 , 7.00 ," 3,826.00 ", - , - , 347.00 ," 3,026.00 ", - 4BFL,C2F1S2," 12,677.00 "," 2,129.00 ", 410.00 , 53.00 , 8.00 ," 1,359.00 ", - , - , 5.00 ," 2,300.00 ", - 4BFM,C2F1S3," 6,883.00 "," 1,188.00 ", 354.00 , - , 5.00 , 992.00 , - , - , 34.00 ," 1,453.00 ", - 4BGK,C2F2S1," 127,982.00 "," 20,267.00 "," 2,184.00 ", 195.00 , 154.00 ," 31,349.00 ", - , - ," 1,458.00 "," 9,381.00 ", - 4BGL,C2F2S2," 830,310.00 "," 435,375.00 "," 1,630.00 ", 181.00 ," 14,655.00 "," 671,150.00 ", - , - ," 1,367.00 "," 41,788.00 ", - 4BGM,C2F2S3," 22,496.00 "," 4,557.00 "," 1,033.00 ", 63.00 , 41.00 ," 7,401.00 ", - , - , 435.00 ," 3,596.00 ", - 4BHK,C2F3S1," 17,375.00 "," 3,407.00 ", 396.00 , - , 82.00 ," 8,612.00 ", - , - , 389.00 ," 1,931.00 ", - 4BHL,C2F3S2," 13,294.00 "," 2,761.00 ", 291.00 , 9.00 , 7.00 ," 5,199.00 ", - , - , 767.00 ," 1,016.00 ", - 4BHM,C2F3S3," 4,854.00 "," 1,441.00 ", 236.00 , - , 7.00 ," 2,867.00 ", - , - , 20.00 ," 1,539.00 ", - 4CFK,C3F1S1," 190,415.00 "," 25,030.00 "," 2,241.00 ", 236.00 , 161.00 ," 12,644.00 ", - , - ," 1,328.00 "," 16,875.00 ", - Totals:,,,,,,,,,,,, ,Non-LUPA," 81,397,579.00 "," 2,971,589.00 "," 534,160.00 "," 53,364.00 "," 677,109.00 "," 28,396,389.00 ", - , 99.00 ," 2,931,092.00 "," 10,590,694.00 ", 4.00 ,LUPA, - , - , - , - , - , - , - , - , - , - , - ,Grid," 81,397,579.00 "," 2,971,589.00 "," 534,160.00 "," 53,364.00 "," 677,109.00 "," 28,396,389.00 ", - , 99.00 ," 2,931,092.00 "," 10,590,694.00 ", 4.00