Overview
The Physicians Explore table is a powerful tool that allows you to find individual physicians or groups of physicians in your available markets.
For an overview of the features and tools on the Explore page, see The Explore page.
Understanding the Metrics
| Metric | Description |
| Name/NPI | This is the physician's name and NPI, as listed in CMS Provider Data (NPI) file. |
| County, ZIP Code, State, address, and City |
This is the county, ZIP Code, city, address, and state that the physician has listed as their primary location of practice. (as pulled from the NPI Registry file)
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| Specialty | This is the specialty that the physician reported in their NPI registry record. |
| Assigned User | If the provider in the row has been assigned to a user in your company, that user's name will show up in this column. |
| % of Total Claims (Billing NPI) | This field is only populated with data when a group billing NPI is selected in the filters. This metric is the percent of claims for the selected billing NPI that originated from the physician listed in the row. |
| Physician Medicare Patients | This is the count of distinct patients for which the selected physician filed a Part B claim during the most recent one year reporting period. |
| Physician SNF Patients | This is the count of the listed physician’s distinct patients who were admitted to SNF care during the reporting period. It is limited to patients who were counted under the three claim types, Followed Patients, Patients 3 Months Prior, and Last Claimed Patients. As such, it is a union of these three claim types, not a total, because a patient could be counted under more than one claim type. |
| Followed Patients | The count of distinct patients who received SNF services during the most recent four quarters with the named physician listed as the certifying physician on the SNF final claim. |
| Patients 3 Months Prior | Patients Three Months Prior is the count of distinct patients where the named physician treated the patient in the 3 months prior to the patient's admission to a SNF. |
| Last claimed patients | This metric is the count of distinct patients for whom the named physician submitted the last professional claim prior to the patient's home health admission. |
| Medicare Days per Stay | The number of days at the SNF covered by Medicare for patients who were discharged from a SNF stay during the most recent four quarters and who were also treated by the named physician within 3 months of their SNF admission. Note: This differs from Average Length of Stay (ALOS) in that it does not include patient days that exceed Medicare coverage. |
| Patient Risk Score |
Average Hierarchical Condition Category (HCC) Patient Risk Score for the named physician.
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| Risk Category | Categorization of your selected provider's Patient Risk Score in comparison to all providers of the same type. |
If this information is not accurate for the provider in the NPI Registry, it is possible that the physician's data could show up in the wrong state. We place physicians in the states in which they register.
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