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U.S. Physician Performance Database Module from CarePrecise
Healthcare provider data

Physician Performance Module (PPM)

U.S. Clinicians' medical procedure volumes & durable medical equipment (DME) & Prosthetics, Orthotics, and Supplies (POS) Orders.

 

The Physician Performance Module (PPM) is a subset of the Authoritative Physician Database, containing the coded procedures and office visits performed by physicians and other clinicians for their Medicare patients, as well as their DME (durable medical equipment) and POS (prosthetics, orthotics, and supply) orders. Physician names and addresses are not included; to link the PPM data to practice and physician contact data, license information, and more, the PPM integrates with CarePrecise Advanced using the NPI number as the relational key. Payment totals, as found in the APD, are not included, but payment data for individual physician procedures are present.

 

Because the source data for the PPM is collected, processed and released once per year by the Centers for Medicare and Medicaid Services, it is offered as a single purchase only.

 

Used in conjunction with CarePrecise Advanced, the PPM offers insight into physicians' medical procedure volumes and charges, and can be used to roll up medical procedure volumes per practice location. Adding the Authoritative Hospital Database, it becomes possible to view medical services volumes within a health system/hospital macrocosm.

 

Physician Performance Module
Available for immediate download: $399 Download the Physician Performance Module

 

Product Details

CarePrecise data sets connect together to form a unified provider database. Add the CarePrecise Advanced data set to the Physician Performance Module, it is possible to see all of the providers who practice together, including physicians, nutritionists, RNs, and all other taxonomies of healthcare providers, as well as their organizations and employers, using CarePrecise's exclusive CoLoCode co-located provider identifier. Medical procedures and orders and charges by individual physicians can this be rolled up to particular practice locations.

 

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Printer-friendly version of the PPM database fields Click for a printer-friendly version of the fields list...

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Data Table/File Name Field Name Description Data Type Size

DB FILE: Procedures.mdb

APD_PhysicianProcedure

Physician procedure volumes and counts of services and patients served, from CMS-collected reporting, according to Medicare Clinician Utilization data.

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Also included is a CSV version of this table.

 NPI National Provider Identifier of clinician Text 10
Proc_Code Procedural code billed by the clinician. Text 24
ServiceCount Frequency of individual clinician's performance of the associated code within the calendar year. Text 10
BeneficiaryCount The number of beneficiaries that received the service or procedure identified by the code. Text 10
MeasureYear The most recent year of procedure data reported by CMS. Text 4

APD_ProcedureDescriptions

Physician procedure volumes according to Medicare Clinician Utilization data. Ongoing extraction from CMS-collected reporting. Abbreviated descriptions.

Also included is a CSV version of this table.

 

 Proc_Code Procedural code billed by the clinician Text 24
ProcedureDescription Lay-friendly description of procedure associated with the procedure code Long Text Long Text

DB FILE: DMEPOS.mdb

APD_PhysicianDMEPOS

Physician Durable Medical Equipment (DME) orders, listing DME ordered by physician, and counts of services, claims, suppliers and patients served, from CMS-collected reporting.

Also included is a CSV version of this table.

 NPI National Provider Identifier of clinician Text 10
DME_Code Code for the specific product or service furnished by the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier. Level II codes. Text 24
Rental Identifies whether the DMEPOS product/service submitted on the supplier's claim is rental or non-rental - Y = rental, N = non-rental Text 1
Suppliers Number of suppliers rendering DMEPOS products/services ordered by the referring provider Text 12
Beneficiaries Number of beneficiaries associated with the supplier DMEPOS products/services ordered by the referring provider. Beneficiary counts fewer than 11 have been suppressed to protect the privacy of Medicare beneficiaries. Text 12
Claims Number of DMEPOS claims submitted by the supplier, reflecting products/services ordered by the referring provider. Aggregated records based on claims fewer than 11 are not included. Text 12
Services Number of DMEPOS products/services rendered by the supplier Text 12
AvgSubmittedCharge Average of the charges that suppliers submit for DMEPOS products/services. Total submitted charges can be calculated by multiplying the AvgSubmittedCharge by the Services. Double  
AvgMedicareAllowAmount Average Medicare allowed amounts for the DMEPOS product/service rendered by suppliers. Allowed: amount Medicare pays, deductible and coinsurance the beneficiary pays, amounts that a third party pays. Total Medicare allowed amounts can be calculated by multiplying the AvgMedicareAllowAmount by the Services. Double  
AvgMedicarePaymentAmount Average amount Medicare paid suppliers after deductible and coinsurance amounts have been deducted for the line item DMEPOS product/service. Total Medicare payment amounts can be calculated by multiplying the AvgMedicarePaymentAmount by the Services. Double  
AvgMedicareStandardAmount Average amount Medicare paid suppliers after deductible and coinsurance amounts have been deducted for the line item DMEPOS product/service. Total Medicare payment amounts can be calculated by multiplying the AvgMedicarePaymentAmount by the Services. Double  
MeasureYear Year of care the data reflects (most recent CMS data release on this physician) Text 4
Classification BETOS Classification Group. High level grouping of the BETOS Classifications into three groups including Durable Medical Equipment, Prosthetic and Orthotic Devices, and Drugs and Nutritional Products. Text 255
RUCA The rural-urban commuting area (RUCA) codes classify U.S. census tracts using measures of population density, urbanization, and daily commuting Text  
EntityType NPI Record Type 1=individual, 2=organization Text  

tAPD_DMEPOSDescriptions

Physician DME order volumes. Ongoing extraction from CMS-collected reporting. Abbreviated descriptions.

Also included is a CSV version of this table.

 DME_Code Code for the specific product or service furnished by the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier Text 24
DME_Description Lay-friendly description of procedure associated with the DMEPOS code Long Text 255

 

DELIVERY

Immediate download from our online store. Optional shipping via mail on a DVD disk or thumb drive is also available. Optional secure, automation-friendly Secure FTP push delivery is available for subscribers.

 

FILE FORMATS

The downloaded zip file contains the PPM in two file formats, each containing identical data:

  • Comma Separated Values (.csv); normalized relational tables; may be used in Excel or imported into any spreadsheet or database software on Windows, Mac or Linux systems.
  • Microsoft Access (.mdb); normalized relational tables.

 

LICENSING

CarePrecise data is licensed for use by the purchaser and may not be redistributed, placed in a data lake, or used to produce a commercial derivative product without an additional license agreement. Special licensing is available. Unless a redistribution or multi-user license is obtained separately, the standard End User License Agreement permits the licensee to use the data in any way desired as long as it is within and for the buyer's own organization and is used by only one user at a time (may not be installed on multiple computers for use by multiple simultaneous users). Alternative licensing options are available for uses that involve distribution of the data or use of the data by more than one user and/or for public viewing, and are purchased separately. For information on licensing CarePrecise data for use in your web applications, products or services, phone 1 (877) 782-2294 extension 9.

 

MORE INFORMATION

Contact CarePrecise Sales at (877) 782-2294, ask@careprecise.com

Data fields shown as contained within product files are populated with content from the CarePrecise LLC central reference data store. This data is compiled and processed on an ongoing basis, with monthly update releases, from public and proprietary sources, including the complete National Plan & Provider Enumeration System (NPPES) data submitted by the providers themselves, Medicare Provider Enrollment Chain and Ownership System (PECOS), List of Excluded Individuals/Entities (LEIE), Medicare claims data, and other US federal sources obtainable under the Freedom of Information Act (FOIA) and provided regularly by the U.S. Department of Health and Human Services and Office of Inspector General of the U.S. Department of Health and Human Services, and from the U.S. Census Bureau, a division of the U.S. Department of Commerce, agencies of the U.S. federal government, the United States Postal Service (USPS), and other public and proprietary sources. With the exception of healthcare provider email addresses and cell phone numbers and some other "premium" data, all data pertaining to individual or organization healthcare providers in CarePrecise LLC products is obtained from sources cleared for public use by the Centers for Medicare and Medicaid Services or other agency of the U.S. federal government, and, as such, the data may be freely used by CarePrecise LLC customers for any purpose except uses prohibited in relevant CarePrecise data use licenses. Healthcare provider email addresses are obtained from CarePrecise LLC partners, including medical journals and other curated contact data. Neither CarePrecise LLC nor its shareholders, partners, affiliates, or vendors are responsible for data maintained by these or other source providers. All HIPAA-covered entity healthcare providers in the U.S. are required under the Federal NPI regulation to provide their information to the NPI Registry, a federal database of healthcare providers, and to update their records within thirty days of any change in that information. Some sources of data are updated at the source every month, others quarterly, annually, or on different release frequencies, and some sources involve a release delay to allow for provider comment prior to release. Review data descriptions on the documentation page or product page for the greatest detail. Data is provided "as is" and in accordance with the Freedom of Information Act (FOIA) and e-FOIA amendments, and relevant data dissemination notices. 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* Not all records are populated with all data. See Data Contents, above.

** Subscription plans include the listed release schedule for the listed time period, with releases approximately monthly or approximately quarterly as indicated. Each release is based on the most recent dissemination from the data sources available at the time acquired for processing the current release.