TABLE D-1 Number of Beneficiaries and Payments for Beneficiaries in Groups A–G

 

(a)

(b)

(c)

(d)

(e)

Group

Number of Beneficiaries

Total Payments (Inpatient, Outpatient, and Carrier)

Total Physician Payments

Total Physician Fee Schedule Payments

Total Physician Fee Schedule Payments with Condition

A—Diabetes, Chronic Heart Failure, & Coronary Artery Disease

33,156

$930,459,017.78

$190,763,248.74

$145,289,007.75

$63,478,717.18

B—Chronic Heart Failure & Coronary Artery Disease; not Diabetes

45,669

$973,068,755.23

$204,803,139.36

$156,203,604.11

$51,811,091.99

C—Chronic Heart Failure & Diabetes; not Coronary Artery Disease

20,084

$343,667,332.55

$77,771,058.17

$57,876,926.78

$17,685,633.11

D—Diabetes & Coronary Artery Disease; not Chronic Heart Failure

52,831

$650,379,010.79

$180,745,583.66

$135,706,435.84

$49,925,585.96

E—Chronic Heart Failure; not Diabetes & Coronary Artery Disease

44,624

$571,843,797.98

$133,677,894.22

$98,210,007.62

$15,564,360.34

F—Coronary Artery Disease; not Diabetes & Chronic Heart Failure

139,998

$1,278,200,988.51

$388,080,620.15

$290,563,134.95

$73,437,377.10

G—Diabetes; not Chronic Heart Failure & Coronary Artery Disease

183,021

$1,010,989,783.78

$358,203,918.84

$254,121,712.13

$58,724,822.67

X—No Condition Category Assigned

1,108,039

$3,659,514,615.32

$1,484,938,239.88

$1,038,689,792.23

 

Total in Groups

519,383

$5,758,608,686.62

$1,534,045,463.14

$1,137,970,829.18

$330,627,588.35

Total in File

1,627,422

$9,418,123,301.94

$3,018,983,703.02

$2,176,660,621.41

$330,627,588.35

NOTES:

Claim lines with invalid provider numbers have been removed from the physician file for all tables.

(a) All beneficiaries with at least one claim line with a valid provider number.

(b) Payments from the inpatient, outpatient, and carrier file.

(c) Carrier file in total, regardless of provider type and fee schedule designation.

(d) Carrier file, only payments associated with the fee schedule.

(e) Carrier file, payments associated with the fee schedule for the condition associated with the disease group.



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