Common use of Quantitative Results Clause in Contracts

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Gambro. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraised: Beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro ▇▇▇▇▇ (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Gambro▇▇▇▇▇. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro Pediatrix (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to GambroPediatrix. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims paid Items included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraised: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D)

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro Ho Medical (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to GambroHo Medical. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro HealthSouth (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in Corporate Integrity Agreement HealthSouth Corporation which such difference resulted in an Overpayment to GambroHealthSouth. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims paid Items included in the sample and the net Overpayment associated with the sample. v. Error Net Overpayment Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraised: Beneficiary beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D).

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro MBPC (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to GambroMBPC. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro the Providers (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Gambrothe Providers. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro ▇▇. ▇▇▇▇▇▇▇▇ (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Gambro▇▇. ▇▇▇▇▇▇▇▇. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro ▇▇▇▇▇▇▇ (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Gambro▇▇▇▇▇▇▇. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Quarterly Claims Review Sample results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro Rotech (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to GambroRotech. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims paid Items included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraised: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D)

Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro ▇▇▇▇▇▇▇ (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Gambro▇▇▇▇▇▇▇. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraisedClaim: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix D

Quantitative Results. i. (a) Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Gambro Tenet (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. (b) Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to GambroTenet. iii. (c) Total dollar amount of all Overpayments in the sample. iv. (d) Total dollar amount of Paid Claims paid Items included in the sample and the net Overpayment associated with the sample. v. (e) Error Rate in the sample. vi. (f) A spreadsheet of the DRG Claims Review results that includes the following information for each Paid Claim appraised: Beneficiary Federal health care program billed, beneficiary health insurance claim number, date of service, procedure code submitted, 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. (See Attachment 1 to this Appendix.) Gambro Healthcare, Inc. Corporate Integrity Agreement Appendix DB-▇ of the CIA)