1. Entity Sample University Period 2014 Q2
Utilization comparisons against benchmarks can identify both risk and opportunity. Just as when high utilization of a high-level code may identify an
elevated threat potential, higher-than-expected utilization of a low level code may identify opportunity when the lower level code should have been
coded at a higher level. Codes identified in this report should be reviewed in the same way that moderate and high risk codes are reviewed.
E&M Opportunity Analysis
Specialty All
Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
37 Provider 313 PEDS.867 $47,233.79 99202 99221 99231
46 Provider 351 INTMED.120 $26,656.82 99202 99212 99231
20 Provider 199 ORTH.1756 $20,707.01 99202 99212
37 Provider 310 PEDS.8103 $17,958.69 99221 99231
16 Provider 163 OBGYN.2146 $16,733.90 99202 99212 99221 99231
11 Provider 93 INTMED.9036 $15,630.92 99221 99231
16 Provider 166 OBGYN.2259 $14,760.07 99201 99211 99282
11 Provider 76 INTMED.1518 $14,577.37 99221
14 Provider 138 NEUSUR.2428 $14,326.97 99201 99212 99231
18 Provider 198 OPHTH.955 $12,552.67 99202 99212 99231
14 Provider 128 NEUSUR.2071 $12,267.88 99202 99221 99231 99281
13 Provider 114 NEUR.3077 $12,051.15 99202 99212 99221 99231
16 Provider 160 OBGYN.1958 $11,664.26 99201 99211 99221 99231 99281
06 Provider 39 CVS.1816 $11,654.23 99201 99212
11 Provider 81 INTMED.2183 $11,118.68
20 Provider 200 ORTH.1759 $10,767.26 99212 99231
37 Provider 304 PEDS.2299 $10,682.36 99221 99231
48 Provider 356 ORTH.1762 $10,603.19 99202 99212
11 Provider 78 INTMED.1633 $10,569.16
14 Provider 126 NEUSUR.1904 $10,530.47 99201 99212
77 Provider 445 SURG.2435 $10,511.84 99202 99212 99221 99231
34 Provider 286 URO.2430 $10,353.86 99201 99212 99221 99231
10 Provider 68 INTMED.170 $10,315.89 99212 99231
Page 1 of 7

2. Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
18 Provider 197 OPHTH.680 $10,278.64 99212
18 Provider 188 OPHTH.1481 $9,830.13 99202 99212
11 Provider 90 INTMED.438 $9,336.85 99221 99231
13 Provider 116 NEUR.7118 $9,005.85 99221
37 Provider 316 PEDS.941 $8,521.89 99221 99231
11 Provider 84 INTMED.2349 $8,409.04 99231
11 Provider 82 INTMED.2265 $8,309.10 99221 99231
11 Provider 79 INTMED.1891 $8,298.71
34 Provider 282 URO.1968 $8,211.66 99221 99231
92 Provider 466 RAD.2424 $8,135.36 99202 99221 99231
18 Provider 195 OPHTH.417 $7,961.98 99202 99212
14 Provider 139 NEUSUR.2434 $7,510.97 99202 99212 99221 99231
24 Provider 220 SURG.1537 $7,298.18 99202 99212 99231
34 Provider 287 URO.2431 $6,852.19 99212 99221
16 Provider 182 OBGYN.648 $6,750.81 99212
14 Provider 137 NEUSUR.2427 $6,585.31 99202 99212 99221 99231
06 Provider 44 CVS.2264 $6,322.37 99221
98 Provider 479 OBGYN.605 $6,267.56 99202 99212 99221
16 Provider 168 OBGYN.2340 $6,230.66 99202
21 Provider 206 CVS.2425 $6,211.67 99221
14 Provider 130 NEUSUR.2075 $6,105.28 99221
18 Provider 194 OPHTH.2356 $6,015.36 99201
14 Provider 135 NEUSUR.2367 $5,998.17 99201 99212 99221 99231
11 Provider 80 INTMED.2155 $5,791.47 99221 99231
39 Provider 326 PEDS.1327 $5,445.07 99212
77 Provider 447 SURG.865 $5,289.24 99212
13 Provider 121 PSYCH.2253 $5,211.86 99202 99212
29 Provider 238 INTMED.2357 $5,000.86 99202 99212 99221
66 Provider 423 INTMED.2409 $4,846.47 99202 99221
Page 2 of 7

3. Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
16 Provider 154 OBGYN.1550 $4,776.25 99201 99211 99282
16 Provider 162 OBGYN.2020 $4,602.51 99202 99221 99231 99282
13 Provider 103 NEUR.2116 $4,557.38 99212
13 Provider 97 NEUR.1212 $4,495.04 99202 99212 99221 99231
10 Provider 73 INTMED.8 $4,480.72 99221
11 Provider 95 INTMED.9061 $4,403.34 99231
77 Provider 446 SURG.504 $4,384.71 99202 99212 99221 99231
50 Provider 373 NEUSUR.1988 $4,337.78 99201 99211
44 Provider 349 PEDS.2257 $4,187.33 99212 99231
07 Provider 54 DERM.1711 $4,128.58 99202 99211
02 Provider 2 SURG.1577 $4,100.99 99202 99212
14 Provider 131 NEUSUR.2130 $4,015.02 99202 99212 99231
16 Provider 173 OBGYN.2364 $3,988.15 99202 99211 99231 99282
29 Provider 241 PEDS.683 $3,973.82 99201 99231
10 Provider 67 INTMED.136 $3,950.90 99221 99231
21 Provider 204 CVS.1648 $3,930.84 99221
14 Provider 134 NEUSUR.2339 $3,854.89 99221 99231
34 Provider 285 URO.2358 $3,731.66 99221
06 Provider 45 CVS.2335 $3,668.61 99221 99231
34 Provider 281 URO.1967 $3,390.27 99202 99212 99221 99231
16 Provider 151 OBGYN.1274 $3,292.83 99201 99212 99231 99282
77 Provider 443 SURG.1841 $3,239.81 99202 99212 99221 99231
37 Provider 299 PEDS.2037 $3,178.20 99221 99231
50 Provider 398 VIL.2407 $3,002.67 99211
18 Provider 193 OPHTH.2263 $2,987.98 99202
24 Provider 219 SURG.1271 $2,987.98 99211
18 Provider 186 OPHTH.109 $2,987.62 99202 99211
14 Provider 125 NEUSUR.1656 $2,965.05 99202 99211
16 Provider 159 OBGYN.1829 $2,955.38 99282
Page 3 of 7

4. Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
06 Provider 51 CVS.2466 $2,888.75 99212
14 Provider 132 NEUSUR.2131 $2,813.52 99202 99212 99231
24 Provider 223 SURG.2362 $2,767.31 99201 99211 99231
37 Provider 291 PEDS.1191 $2,367.17 99221 99231
97 Provider 469 DERM.1713 $2,351.77
44 Provider 348 PEDS.1818 $2,337.80 99231
04 Provider 33 OTO.2439 $2,317.38 99201 99212
11 Provider 87 INTMED.2450 $2,296.60
16 Provider 165 OBGYN.2199 $2,286.93 99231 99282
20 Provider 201 ORTH.1761 $2,260.78 99211
11 Provider 94 INTMED.9060 $2,253.61 99221 99231
77 Provider 442 SURG.1354 $2,204.54 99212 99221 99231
50 Provider 381 OBGYN.2200 $2,119.28 99201
16 Provider 171 OBGYN.2361 $2,074.50 99202 99212 99282
17 Provider 185 INTMED.2459 $2,029.36 99221 99231
29 Provider 233 INTMED.1373 $1,995.33 99212
16 Provider 152 OBGYN.1346 $1,946.25 99211 99281
66 Provider 421 INTMED.1025 $1,885.00
04 Provider 32 OTO.2422 $1,831.62 99202 99212
24 Provider 221 SURG.175 $1,807.62 99201 99212
37 Provider 296 PEDS.178 $1,777.17
50 Provider 383 OBGYN.2448 $1,777.17 99282
11 Provider 92 INTMED.8812 $1,729.17
97 Provider 470 DERM.2282 $1,601.28 99202 99212
29 Provider 235 INTMED.1887 $1,576.20 99202 99212 99221 99231
50 Provider 377 OBGYN.1479 $1,542.53
18 Provider 196 OPHTH.572 $1,497.03
37 Provider 308 PEDS.591 $1,477.69
07 Provider 56 DERM.1827 $1,383.48 99202 99211
Page 4 of 7

5. Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
50 Provider 396 SURG.1435 $1,378.10 99202 99212
06 Provider 37 CVS.1649 $1,262.04 99212
37 Provider 301 PEDS.2170 $1,255.95 99221 99231
07 Provider 53 DERM.1710 $1,228.36 99202
44 Provider 332 INTMED.072 $1,216.90 99221 99231
18 Provider 187 OPHTH.1132 $1,203.65
14 Provider 123 NEUSUR.1504 $1,187.53
13 Provider 113 NEUR.2388 $1,153.85 99221 99231
16 Provider 161 OBGYN.1995 $1,150.27 99212
41 Provider 328 OPHTH.795 $1,145.25 99212
81 Provider 456 PEDS.2196 $1,008.77 99231
11 Provider 85 INTMED.2417 $998.02
50 Provider 378 OBGYN.1751 $990.86
16 Provider 178 OBGYN.2442 $978.68 99282
50 Provider 374 NEUSUR.2136 $912.76 99202 99211
66 Provider 422 INTMED.1249 $883.03
29 Provider 239 INTMED.7847 $847.57 99211 99221
50 Provider 359 DERM.2399 $797.06 99202 99212
42 Provider 331 OBGYN.2469 $768.04 99201
50 Provider 376 OBGYN.1334 $743.32
77 Provider 449 SURG.2432 $726.49 99202 99212 99231
34 Provider 284 URO.2138 $720.04 99221 99231
13 Provider 105 NEUR.2144 $706.07
06 Provider 40 CVS.2157 $705.35 99221 99231
13 Provider 111 NEUR.2287 $643.02 99212 99231
14 Provider 136 NEUSUR.2396 $536.63 99202 99212 99231
14 Provider 122 NEUSUR.1350 $528.39 99221
16 Provider 180 OBGYN.293 $507.25 99201
13 Provider 117 NEUR.746 $496.86 99212
Page 5 of 7

6. Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
50 Provider 379 OBGYN.2097 $491.49
42 Provider 329 OBGYN.1542 $466.77 99202 99282
82 Provider 457 INTMED.2238 $437.04 99212
18 Provider 189 OPHTH.1971 $399.78 99202 99212
16 Provider 179 OBGYN.2445 $395.48 99281
37 Provider 317 PEDS.991 $340.67 99221 99231
34 Provider 283 URO.1969 $337.81 99212 99221 99231
81 Provider 452 PEDS.1182 $314.52 99231
40 Provider 327 ORTH.1763 $285.15 99212
42 Provider 330 OBGYN.2386 $267.60 99282
37 Provider 303 PEDS.2275 $256.49
16 Provider 170 OBGYN.2359 $254.34 99212 99282
50 Provider 375 NEUSUR.2366 $222.46 99231
50 Provider 392 PEDS.2310 $209.56
16 Provider 149 OBGYN.1074 $205.62 99211 99231 99282
50 Provider 405 PEDS.2483 $187.71
81 Provider 455 PEDS.2194 $178.40 99231
50 Provider 395 PEDS.448 $176.25
50 Provider 382 OBGYN.2331 $147.59
81 Provider 454 PEDS.2186 $140.78 99231
06 Provider 41 CVS.2162 $139.71 99202
81 Provider 451 PEDS.1165 $135.05
81 Provider 453 PEDS.2107 $124.31
50 Provider 388 PEDS.1767 $109.98 99212
44 Provider 334 INTMED.1456 $92.78
97 Provider 475 OTO.1812 $91.71
16 Provider 181 OBGYN.383 $73.79
50 Provider 368 INTMED.578 $68.42 99221
16 Provider 153 OBGYN.1522 $52.30 99282
Page 6 of 7

7. Specialty
Code Provider Name Provider Id Opportunity
New
Office
Est
Office
Init
Hosp
Subseq
Hospital
ED
Services
Comp
Nursing
Visit
Subseq
Nursing
Visit
10 Provider 70 INTMED.2003 $46.21 99221
24 Provider 222 SURG.2182 $44.42 99201 99212
15 Provider 146 PSYCH.1625 $22.93 99212
97 Provider 476 OTO.2395 $16.12
Page 7 of 7