DRILL DOWN TABLES. Episodes Attributed to Your Medical Group Practice																																						
										* Indicates that the EP name was suppressed to protect privacy.																												
																																						
Beneficiary/Episode Information								"TABLE 3. Breakdown of Episode Costs from Claims Billed or Ordered by EPs or Facilities OUTSIDE YOUR MEDICAL GROUP PRACTICE					
"									 TABLE 3 (cont.). Breakdown of Episode Costs from Claims Billed or Ordered by EPs or Facilities OUTSIDE YOUR MEDICAL GROUP PRACTICE																					
																	 Inpatient Hospital			Post-Acute Care			Outpatient Hospital and Physician Office Services					Emergency Room Services				Ancillary Services in All Non-Inpatient Settings			Hospice Care	Other Services		
"        
Episode ID

"	"        

Beneficiary HIC"	"

Gender"	"

Date of Birth"	"Episode Type

"		"Episode Start
Date"		"
# EPs Outside Your Medical Group Practice Treating Episode    "		Top Billing EP Outside Your Medical Group Practice Treating Episode	Hospital Billing Earliest in Episode	Hospital Billing Second in Episode		Skilled Nursing Facilities or Home Health Agencies Billing Earliest in Episode	Skilled Nursing Facilities or Home Health Agencies Billing Second in Episode 	"All Cost   
(Non-Risk-
Adjusted)  "	" Inpatient Hospital: 
Trigger 
"	" Inpatient Hospital: 
Readmission"	" Physician Services 
During Hospitalization "	 Skilled Nursing	" Home Health 
"	" Inpatient Rehabilitation or 
Long Term Care Hospital"	 Outpatient PT/OT/SLP	 Dialysis	" Evaluation & Management 
Services"	" Major Procedures and 
Anesthesia"	" Ambulatory/ Minor 
Procedures"	" Evaluation & Management 
Services"	 Procedures	"Lab/ Pathology/
 Other Tests"	 Imaging	"Lab/ Pathology/ 
Other Tests"	 Imaging	"Durable Medical 
Equipment/ Supplies"	 Hospice	 Ambulance	 Chemo. And Part B Drugs	 All Other Services
1000000000000001		M 		ACS with CABG				0			HOSPITAL E					$68	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$29	$39	$0	$0	$0	$0	$0
1000000000000002		F 		ACS with PCI				1		*	HOSPITAL F					$105	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$30	$0	$0	$0	$0	$23	$52	$0	$0	$0	$0	$0
1000000000000003		F 		ACS without PCI/CABG				1		*	HOSPITAL G					"$1,257"	$0	$0	$100	$0	$0	$0	$0	$0	$476	$0	$0	$155	$0	$0	$0	$396	$129	$0	$0	$0	$0	$0
1000000000000006		M 		Cellulitis				3		Dr. S						$343	$0	$0	$343	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
1000000000000007		F 		COPD/asthma				0								$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
1000000000000009		F 		Chronic atrial fibrillation/flutter				1		*						$15	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$15
1000000000000010		F 		GI hemorrhage				5		Dr. T	HOSPITAL A	HOSPITAL F				"$1,197"	$0	$0	$949	$0	$0	$0	$0	$0	$0	$0	$0	$130	$0	$0	$0	$94	$24	$0	$0	$0	$0	$0
1000000000000011		M 		Chronic CHF				0								$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
1000000000000012		M 		IHD with ACS				0								$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
1000000000000013		F 		IHD without ACS				2		Dr. U						$203	$0	$0	$0	$0	$0	$0	$0	$0	$188	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$14
1000000000000014		F 		Kidney/urinary tract infection				3		Dr. V						$299	$0	$0	$299	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
1000000000000018		M 		Pneumonia with IP hospitalization				8		Dr. Y						$188	$0	$0	$188	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
1000000000000019		M 		Pneumonia without IP hospitalization				4		Dr. Z						$12	$0	$0	$12	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
2000000000000008		F 		"Acute COPD/asthma, inpatient exacerbation"				1		*						$56	$0	$0	$0	$0	$0	$0	$0	$0	$56	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
9000000000000004		M 		CABG				10		Dr. Q	HOSPITAL H					"$1,337"	$0	$0	$333	$0	$0	$0	$0	$0	$0	$0	$0	$302	$0	$0	$0	$300	$366	$0	$0	$0	$0	$36
9000000000000005		F 		CABG without ACS				6		Dr. R	HOSPITAL F			HOME HEALTH B		"$5,841"	$0	$0	$31	$0	"$5,443"	$0	$0	$0	$296	$0	$0	$0	$0	$0	$0	$71	$0	$0	$0	$0	$0	$0
9000000000000015		M 		Permanent pacemaker system replacement/insertion				5		Dr. W	HOSPITAL E					$892	$0	$0	$175	$0	$0	$0	$0	$0	$37	$0	$0	$453	$0	$0	$0	$50	$58	$0	$0	$0	$0	$119
9000000000000016		M 		PCI				2		Dr. U						$103	$0	$0	$103	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0
9000000000000017		M 		PCI without ACS				5		Dr. X	HOSPITAL I					"$1,253"	$0	$0	"$1,188"	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$42	$23	$0	$0	$0	$0	$0
