Common use of Quantitative Results Clause in Contracts

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did not have appropriate documentation of medical necessity and resulted in an Overpayment to Progenity. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Practitioner differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityPractitioner. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityPractitioner. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityPractitioner. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity CHSI (Claim Submitted) differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenityclaim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented Submitted differed from the Correct Claim and in which such documentation errors difference resulted in an Overpayment to ProgenityCHSI. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did not have appropriate documentation of medical necessity and resulted in an Overpayment to Progenity. iv. Total dollar amount of all Overpayments in the Claims Review Sample.Discovery Sample and the Full Sample (if applicable). Community Health Systems, Inc. 6 Corporate Integrity Agreement - Appendix B v. iv. Total dollar amount of Paid Claims included in the Claims Review Discovery Sample and the Full Sample and the net Overpayment associated with the Discovery Sample and the Full Sample. v. Error Rate in the Discovery Sample and the Full Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Inpatient Medical Necessity and Appropriateness Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount. vii. If a Full Sample is performed, the methodology used by the IRO to estimate the actual Overpayment in the Population and the amount of such Overpayment.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity ▇▇▇▇▇ differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity▇▇▇▇▇. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity▇▇▇▇▇. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity▇▇▇▇▇. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Genova differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityGenova. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityGenova. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityGenova. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity GLML differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityGLML. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityGLML. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityGLML. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity ▇▇▇▇ Clinic differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity▇▇▇▇ Clinic. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity▇▇▇▇ Clinic. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity▇▇▇▇ Clinic. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. The IRO shall provide the following information for each Quarterly Claims Sample:‌‌ i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity ▇▇▇▇▇▇ differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity▇▇▇▇▇▇. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity.▇▇▇▇▇▇.‌‌ iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity▇▇▇▇▇▇. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample.Sample.‌ v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample.Sample.‌ vi. Error Rate Rates in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment Overpayments in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity ▇▇▇▇▇▇▇▇ differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityKlurfeld. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityKlurfeld. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityKlurfeld. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity MMW differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityMMW. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityMMW. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityMMW. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity OGCC differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityOGCC. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityOGCC. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityOGCC. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. ‌‌ i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Providence differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityProvidence. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityProvidence. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityProvidence. iv. Total dollar amount of all Overpayments in the Claims Review Sample.Sample.‌ v. Total dollar amount of Paid Claims included in the Claims Review Sample.Sample.‌ vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample.Sample.‌ vii. An estimate of the actual Overpayment in the Population at the mean point estimate.estimate.‌ viii. A spreadsheet of the Claims Review results that includes the following information for each each‌ Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor▇▇▇▇▇, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity UCI differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityUCI. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityUCI. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityUCI. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. ‌‌ i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Prime differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityPrime. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityPrime. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityPrime. iv. Total dollar amount of all Overpayments in the Claims Review Sample.Sample.‌ v. Total dollar amount of Paid Claims included in the Claims Review Sample.Sample.‌ vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.amount.‌

Quantitative Results. ‌‌ i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity CHSI differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityCHSI. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityCHSI. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityCHSI. iv. Total dollar amount of all Overpayments in the Claims Review Sample.Sample.‌ v. Total dollar amount of Paid Claims included in the Claims Review Sample.Sample.‌ vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.amount.‌

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity PGS differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityPGS. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityPGS. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityPGS. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Health Quest differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityHealth Quest. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityHealth Quest. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityHealth Quest. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity LHMC differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityLHMC. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityLHMC. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityLHMC. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Gardi differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityGardi. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityGardi. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityGardi. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity▇▇▇▇▇▇▇. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity▇▇▇▇▇▇▇. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity▇▇▇▇▇▇▇. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity LFAC differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityLFAC. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityLFAC. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityLFAC. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. For each Selected Location and Claims Review Sample, the IRO shall identify the following: i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity PFH differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityPFH. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityPFH. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityPFH. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population for the Selected Location at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. ‌‌ i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Gamma differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityGamma. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityGamma. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityGamma. iv. Total dollar amount of all Overpayments in the Claims Review Sample.Sample.‌ v. Total dollar amount of Paid Claims included in the Claims Review Sample.Sample.‌ vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.amount.‌

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity SPI differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenitySPI. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenitySPI. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenitySPI. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Radeas differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityRadeas. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityRadeas. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityRadeas. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity TPRC differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityTPRC. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityTPRC. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityTPRC. iv. Total number and percentage of instances in which the IRO determined that (a) an order for urine drug testing was not properly recorded in the Urine Drug Testing Report, (b) urine drug testing results were not reviewed and/or appropriately utilized by the Ordering Provider, or (c) an ordered urine drug test was not medically reasonable and necessary. v. Total dollar amount of all Overpayments in the Claims Review Sample. v. vi. Total dollar amount of Paid Claims included in the Claims Review Sample. vivii. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. viiviii. An estimate of the actual Overpayment in the Population at the mean point estimate. viiiix. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity FHG differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityFHG. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityFHG. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityFHG. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Center for Pain Management differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityCenter for Pain Management. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityCenter for Pain Management. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityCenter for Pain Management. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity CHSI differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityCHSI. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityCHSI. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity.CHSI. Community Health Systems, Inc. Corporate Integrity Agreement, Amended – Appendix B iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Khanna differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityKhanna. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityKhanna. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityKhanna. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Qamar differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityQamar. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityQamar. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityQamar. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity Alaska Neurology differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityAlaska Neurology. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityAlaska Neurology. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityAlaska Neurology. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity UMHS differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityUMHS. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityUMHS. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityUMHS. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the Claims Review IRO determined that the coding of the Paid Claims submitted by Progenity ▇▇▇▇▇▇▇ differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity▇▇▇▇▇▇▇. ii. Total number and percentage of instances in which the Claims Review IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to Progenity▇▇▇▇▇▇▇. iii. Total number and percentage of instances in which the Claims Review IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to Progenity▇▇▇▇▇▇▇. iv. Total dollar amount of all Overpayments in the Claims Review Sample. v. Total dollar amount of Paid Claims included in the Claims Review Sample. vi. Error Rate in the Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Claims Review Sample by the total dollar amount associated with the Paid Claims in the Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Claims Review IRO), correct allowed amount (as determined by the Claims Review IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity APS differed from what should have been the correct coding and in which such difference resulted in an Overpayment to ProgenityAPS. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented and in which such documentation errors resulted in an Overpayment to ProgenityAPS. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that did were not have appropriate documentation of medical necessity medically necessary and resulted in an Overpayment to ProgenityAPS. iv. Total dollar amount of all Overpayments in the Quarterly Claims Review Sample. v. Total dollar amount of Paid Claims included in the Quarterly Claims Review Sample. vi. Error Rate in the Quarterly Claims Review Sample. The Error Rate shall be calculated by dividing the Overpayment in the Quarterly Claims Review Sample by the total dollar amount associated with the Paid Claims in the Quarterly Claims Review Sample. vii. An estimate of the actual Overpayment in the Population at the mean point estimate. viii. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted (e.g.submitted, DRG, CPT code, etc.), procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.