1. Entity Sample University Period 2014 Q2
E&M Analysis
This report contains a wealth of data about most E&M categories. By default, the provider is compared against both state and national benchmarks.
If there are at least three other providers in the practice with the same specialty, we also compare against the practice average for that specialty.
Provider 7: General Surgery
Risk Score: 100
New Office Visits Risk score: 67
99201 99202 99203 99204 99205
0
20
40
60
80
100
120
Percent
Frequency
Provider Practice National State
99201 99202 99203 99204 99205
-40.00
-20.00
0.00
20.00
40.00
60.00
80.00
100.00
120.00
RVU
RVU Exposure
Page 1 of 10

2. Established Office Visits Risk score: 3
99211 99212 99213 99214 99215
0
10
20
30
40
50
60
70
Percent
Frequency
Provider Practice National State
99211 99212 99213 99214 99215
-20.00
-10.00
0.00
10.00
20.00
30.00
40.00
50.00
RVU
RVU Exposure
Initial Observation Care Risk score: 0
99218 99219 99220
0
5
10
15
20
25
30
35
40
45
Percent
Frequency
Provider Practice National State
99218 99219 99220
0.00
0.20
0.40
0.60
0.80
1.00
1.20
RVU
RVU Exposure
Page 2 of 10

3. Initial Hospital Visits Risk score: 97
99221 99222 99223
0
20
40
60
80
100
120
Percent
Frequency
Provider Practice National State
99221 99222 99223
-150.00
-100.00
-50.00
0.00
50.00
100.00
150.00
200.00
250.00
300.00
RVU
RVU Exposure
Subsequent Hospital Visits Risk score: 33
99231 99232 99233
0
20
40
60
80
100
120
Percent
Frequency
Provider Practice National State
99231 99232 99233
-10.00
-5.00
0.00
5.00
10.00
15.00
20.00
RVU
RVU Exposure
Page 3 of 10

4. Observation or Inpatient Care Service Risk score: 0
99234 99235 99236
0
10
20
30
40
50
60
70
Percent
Frequency
Provider Practice National State
99234 99235 99236
0.00
0.20
0.40
0.60
0.80
1.00
1.20
RVU
RVU Exposure
Discharge Days Risk score: 0
99238 99239
0
10
20
30
40
50
60
70
80
90
100
Percent
Frequency
Provider Practice National State
99238 99239
0.00
0.20
0.40
0.60
0.80
1.00
1.20
RVU
RVU Exposure
Page 4 of 10

5. New/Established Office Consultations Risk score: 53
99241 99242 99243 99244 99245
0
10
20
30
40
50
60
70
80
90
Percent
Frequency
Provider Practice National State
99241 99242 99243 99244 99245
-5.00
0.00
5.00
10.00
15.00
20.00
RVU
RVU Exposure
Initial Inpatient Consultations Risk score: 100
99251 99252 99253 99254 99255
0
20
40
60
80
100
120
Percent
Frequency
Provider Practice National State
99251 99252 99253 99254 99255
-100.00
-50.00
0.00
50.00
100.00
150.00
200.00
250.00
300.00
350.00
RVU
RVU Exposure
Page 5 of 10

6. Emergency Department Services Risk score: 69
99281 99282 99283 99284 99285
0
20
40
60
80
100
120
Percent
Frequency
Provider Practice National State
99281 99282 99283 99284 99285
-3.00
-2.00
-1.00
0.00
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
RVU
RVU Exposure
Comprehensive Nursing Facility Assessments Risk score: 0
99304 99305 99306
0
10
20
30
40
50
60
Percent
Frequency
Provider Practice National State
99304 99305 99306
0.00
0.20
0.40
0.60
0.80
1.00
1.20
RVU
RVU Exposure
Page 6 of 10

7. Subsequent Nursing Facility Assessments Risk score: 0
99307 99308 99309 99310
0
10
20
30
40
50
60
Percent
Frequency
Provider Practice National State
99307 99308 99309 99310
0.00
0.20
0.40
0.60
0.80
1.00
1.20
RVU
RVU Exposure
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8. Critical Care
99291
99292
99468
99469
99471
99472
99475
99476
0
2
4
6
8
10
12
14
16
18
Percent
Expected Utilization vs Observed
Observed Expected
Prolonged Care
99354
99355
99356
99357
99358
99359
0
0.2
0.4
0.6
0.8
1
1.2
Percent
Expected Utilization vs Observed
Observed Expected
Page 8 of 10

9. Time-based Care Ratios
Description of Service for Comparison Provider National Variance from National State Variance from State
Adult Critical Care - 99291 to 99292 25.25 10.20 147.4 % 13.73 83.9 %
Pediatric Critical Care - 99475 to 99476 0.00 0.00 0.0 % 0.00 0.0 %
Pediatric Critical Care - 99471 to 99472 0.00 0.00 0.0 % 0.00 0.0 %
Neonate Critical Care - 99468 to 99469 0.00 0.00 0.0 % 0.00 0.0 %
Prolonged outpatient service - 99354 to 99355 0.00 26.62 -100.0 % 26.38 -100.0 %
Prolonged inpatient service - 99356 to 99357 0.00 6.60 -100.0 % 16.14 -100.0 %
Prolonged E&M service - 99358 to 99359 0.00 12.81 -100.0 % 0.00 0.0 %
Intercategory Ratios
Description of Service for Comparison Provider National Variance from National State Variance from State
Office Consult to New Office Visit 0.36 0.00 N/A 0.00 N/A
Discharge Days to Initial Hospital Visit 0.00 0.10 -100.0 % 0.06 -100.0 %
Established Office Visit to New Office Visit 0.91 2.52 -63.9 % 2.43 -62.6 %
Subsequent Hospital Visit to Initial Hospital Visit 0.08 2.13 -96.3 % 1.93 -95.9 %
Inpatient Consultations to Initial Hospital Visit 0.78 0.00 N/A 0.00 N/A
Inpatient Consultations to Subsequent Hospital Visit 9.83 0.00 N/A 0.00 N/A
Initial Observation Care to Initial Hospital Visit 0.00 0.03 -100.0 % 0.01 -100.0 %
Observation or Inpatient Care to Initial Observation 0.00 0.29 -100.0 % 0.71 -100.0 %
Observation or Inpatient Care to Initial Hospital Visit 0.00 0.01 -100.0 % 0.01 -100.0 %
Global Category Percent
Category Descriptions Provider National Variance from National State Variance from State
Total Number of E&M Services Calculated 298
New Office Visits to All E&M Codes 7.4 % 16.6 % -55.6 % 0.16 -54.8 %
Established Office Visits to All E&M codes 6.7 % 41.8 % -84.0 % 0.40 -83.1 %
Initial Hospital Visits to All E&M Codes 25.5 % 10.4 % 146.1 % 0.12 113.6 %
Subsequent Hospital Visits to All E&M Codes 2.0 % 22.1 % -90.9 % 0.23 -91.3 %
Outpatient Consults to All E&M Codes 2.7 % 0.1 % N/A 0.00 0.0 %
Inpatient Consults to All E&M Codes 19.8 % 0.0 % N/A 0.00 0.0 %
Emergency Department Services to All E&M Codes 0.7 % 1.3 % -47.7 % 0.01 -16.3 %
Comprehensive Nursing Home Visits to All E&M Codes 0.0 % 0.4 % -100.0 % 0.01 -100.0 %
Subsequent Nursing Home Visits to All E&M Codes 0.0 % 2.8 % -100.0 % 0.03 -100.0 %
Category Summaries Provider National Variance from National State Variance from State
All Office Visits to All E&M Codes 14.1 % 58.4 % -75.9 % 56.03 -99.7 %
All Hospital Visits to All E&M Codes 27.5 % 32.5 % -15.2 % 35.02 -99.2 %
All Consults to All E&M Codes 22.5 % 0.1 % N/A 0.00 N/A
Page 9 of 10

10. Category Descriptions Provider National Variance from National State Variance from State
All Nursing Home Visits to All E&M Codes 0.0 % 3.2 % -100.0 % 4.19 -100.0 %
All E&M Visits to All Procedures 42.6 % 49.4 % -13.8 % 0.49 -13.6 %
Utilization Distribution Calculations by Category
Category Provider RVU National RVU Variance from National State RVU Variance from State
All 0.00 0.00 0.0 % 0.00 0.0 %
New Office Visits 5.65 3.60 57.0 % 3.86 46.6 %
Established Office Visits 3.12 2.10 48.6 % 2.18 43.3 %
Initial Observation Care 0.00 3.94 -100.0 % 3.98 -100.0 %
Initial Hospital Visits 5.70 4.39 29.8 % 4.54 25.5 %
Subsequent Hospital Visits 2.91 1.85 57.6 % 1.92 51.2 %
Observation or Inpatient Care Service 0.00 4.73 -100.0 % 4.79 -100.0 %
Discharge Days 0.00 2.14 -100.0 % 2.28 -100.0 %
New/Established Office Consultations 5.35 4.16 28.7 % 3.85 39.1 %
Initial Inpatient Consultations 5.64 3.42 64.8 % 2.83 99.2 %
Emergency Department Services 4.85 3.13 54.9 % 3.15 54.0 %
Comprehensive Nursing Facility Assessments 0.00 3.56 -100.0 % 4.11 -100.0 %
Subsequent Nursing Facility Assessments 0.00 2.96 -100.0 % 3.03 -100.0 %
Charge Differential Calculations by Category
Category
Provider
RVU
Expected RVU
(National)
RVU Differential
(National)
Expected RVU
(State)
RVU Differential
(State)
New Office Visits 124.40 79.25 45.15 84.82 39.58
Established Office Visits 62.32 41.96 20.36 43.50 18.82
Initial Observation Care 0.00 0.00 0.00 0.00 0.00
Initial Hospital Visits 433.20 333.92 99.28 345.24 87.96
Subsequent Hospital Visits 17.46 11.08 6.38 11.55 5.91
Observation or Inpatient Care Service 0.00 0.00 0.00 0.00 0.00
Discharge Days 0.00 0.00 0.00 0.00 0.00
New/Established Office Consultations 42.80 33.25 9.55 30.77 12.03
Initial Inpatient Consultations 332.57 201.82 130.75 166.97 165.60
Emergency Department Services 9.70 6.26 3.44 6.30 3.40
Comprehensive Nursing Facility Assessments 0.00 0.00 0.00 0.00 0.00
Subsequent Nursing Facility Assessments 0.00 0.00 0.00 0.00 0.00
RVU Totals 1,022.45 707.53 314.92 689.14 333.31
Dollar Totals (CF = 35.8228) 36,627.02 25,345.86 11,281.16 24,687.06 11,939.97
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