Provide Dollars. Percent. Percent. Percent. Multi, For 14 the total N/A OK. N/A OK. N/A OK. N/A OK. dollars From 0 to 1: ACO, paid for 10000000000000000. Unknown 2: PCMH, FFS-based Note: 3: Medical non-visit Percentage functions. provided (see in this row do not for total 100% in CY 2015 or most recent 12 months. Provide Dollars. Percent. Percent. Percent. Multi, For 15 the total N/A OK. N/A OK. N/A OK. N/A OK. dollars From 0 to 1: ACO, paid for 10000000000000000. Unknown 2: PCMH, Note: 3: Medical Percentage non-visit provided functions. in this row (see do not total 100% for ) in CY 2015 or most recent 12 months. Provide Dollars. Percent. Percent. Percent. Multi, For 16 the total N/A OK. N/A OK. N/A OK. N/A OK. dollars From 0 to 1: ACO, paid to 10000000000000000. Unknown 2: PCMH, providers Note: 3: Medical whose Percentage contract provided contains in this row other types of
Percentage Percentage Percentage Provide the total dollars paid for FFS-based non-visit functions. (see for in CY 2015 or most recent 12 months. Dollars. N/A OK. From 0 to 10000000000000000. Percent. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical For Unknown Note: provided in this row do not total 100% 14 Provide the total dollars paid for non-visit functions. (see for in CY 2015 or most recent 12 months. Dollars. N/A OK. From 0 to 10000000000000000. Percent. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical For Unknown Note: provided in this row do not total 100% 15 Provide the total dollars paid to providers whose contract contains other types of Dollars. N/A OK. From 0 to 10000000000000000. Percent. N/A OK. Percent. N/A OK. Percent. N/A OK. Multi, 1: ACO, 2: PCMH, 3: Medical For Unknown Note: provided in this row 16 )
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx