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Table 5 Healthcare Provider Clusters: HCPCS Code G0202

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

  

Cluster Centroids (Average)

Cluster #

Relative Size (Frequency)

1

12.1% (2171)

2

27.7% (4834)

3

3.5% (620)

4

56.4% (9848)

Healthcare Provider Attributes

Provider Type

Diagnostic Radiology (76.9%)

Obstetrics/Gynecology (20.64%)

Diagnostic Radiology (66.1%)

Family Practice (15.76%)

Internal Medicine (12.83%)

Diagnostic Radiology (43.9%)

Independent Diagnostic Testing Facility (40.81%)

Diagnostic Radiology (97.9%)

Medical Procedure Attributes

Place of Service

Office (55%)

Office (100%)

Office (96.5%)

Office (91.2%)

Service Volume

666.22

178.07

602.31

263.33

Unique Beneficiary

664.40

177.61

534.18

263.30

Service/Unique Beneficiary

1.00

1.00

1.29

1.00

Medicare Allowed Amount

$81.13

$125.99

$101.08

$35.32

Medicare Payment Amount

$79.22

$123.12

$98.88

$34.57

Excess Charge Ratio

2.65

2.30

2.43

3.04

Medical Practice Attributes

Total Unique HCPCS codes submitted

64.80

147.08

149.50

171.38

Total Unique Beneficiary

1574.76

1903.67

3011.00

2931.56

Overall Excess Charge Ratio

3.00

3.28

4.03

3.96

Demographic and Socio-economic Attributes

Beneficiary Average Risk Score

1.02

1.37

1.26

1.59

Beneficiary Dual Percentage

16.95

23.31

20.64

27.82

Location Mix (Urban: Rural: Very Rural)

(94.5%: 5.3%: 0.2%)

(87.4%: 10.3%: 2.3%)

(87.9%: 11.5%: 0.6%)

(83.9%: 14.0%: 2.2%)