"Supplementary Exhibit 1. Physicians and Non-Physician Eligible Professionals Billing Under Your TIN, Selected Characteristics"				"Supplementary Exhibit 1. Physicians and Non-Physician Eligible Professionals Billing Under Your TIN, Selected Characteristics"			
							
							
NPI	Name	Physician	Non-Physician Eligible Professional	Specialty Designation	Identified via PECOS	Identified via Billings	Date of Last Claim Billed Under TIN
#	John Doe	-	X	Licensed Clinical Social Worker	X	X	06/24/14
#	John Smith	X	-	Internal Medicine	X	X	05/30/14
							
 Crosses indicate terms to be defined through the hover-over function.				 Crosses indicate terms to be defined through the hover-over function.			
