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Table 2 Attributes used in the analysis

From: Discovering healthcare provider behavior patterns through the lens of Medicare excess charge

Attribute Example/Definition
Healthcare Provider
 Type (Specialty) Cardiology, Family Practice, …
 Gender Male/Female
 Credential M.D.; D.O.; CRNP,…
 Entity Code Individual/Organization
Medical Procedure
 Place of Service Office/Facility
 Service Volume Number of services performed
 Number of Unique Beneficiaries Number of distinct Medicare beneficiaries receiving the service
 Number of Visits Number of distinct Medicare beneficiary/per day services
 Number of Services Per Unique Beneficiarya Number of Services per unique beneficiary
 Number of Service Per Visita Number of services per visit
 Medicare Allowed Amount Average of the Medicare allowed amount for the service
 Submitted Charge Amount Average of the charges that the provider submitted for the service
 Medicare Payment Amount Average amount that Medicare paid
 Excess Charge Ratioa Average Submitted Charge Amount/ Average Medicare Allowed Amount
Medical Practice
 Total Number of Unique Procedures Total number of unique services provided by the provider
 Total Service Volume Total services performed by the provider across all procedures
 Total Number of Unique Beneficiaries Total number of distinct Medicare beneficiaries serviced by the provider
 Total Medicare Allowed Amount Total Medicare allowed amount for all services
 Total Submitted Charge Amount Total charge the provider submitted for all services
 Total Medicare Payment Amount Total amount that Medicare paid to the provider
 Overall Excess Charge Ratioa Total Submitted Charge amount/ Total Medicare Allowed amount
Demographic and Socioeconomic
 Location Urban/Rural/Very Rural
 Beneficiary Average Age % of the provider’s beneficiaries qualifying for both Medicare and Medicaid
 Beneficiary Male %a % of male beneficiaries
 Beneficiary Female %a % of female beneficiaries
 Beneficiary White %a % of beneficiaries who identify themselves as non-Hispanic white
 Beneficiary Average Risk Score Average age of the beneficiaries serviced by the provider
 Beneficiary Dual Percentagea Average risk score of beneficiaries serviced by the provider
  1. attributes marked with a are derived attributes