UnitedHealth Premium Physician Designation Program Episode Treatment Groups (ETG ) Description and Specialty

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1 UnitedHealth Premium Physician Designation Program Episode Treatment Groups (ETG ) Description and Specialty Acne Family Medicine, Internal Medicine, Pediatrics Acute Bronchitis Allergy, Cardiology, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology Acute Renal Failure Nephrology Acute Renal Inflammation Nephrology Acute Sinusitis Allergy, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology, Adult Rheumatoid Arthritis Internal Medicine, Agranulocytosis Infectious Disease AIDS Infectious Disease Allergic Rhinitis Allergy, Family Medicine, Internal Medicine, Pediatrics, Pulmonology Alzheimer s Disease Neurology Aortic Aneurysm Cardiology Arterial Inflammation Cardiology, Asthma Allergy, Cardiology, Family Medicine, Internal Medicine, Pediatrics, Pulmonology Atherosclerosis Cardiology Atrial Fibrillation & Flutter Cardiology Autoimmune Rheumatoid Disease Except Lupus Bacterial & Fungal Meningitis Infectious Disease Bacterial Lung Infection Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology Brain Trauma Neurology

2 Bursitis/Tendonitis - Unspecified Family Medicine, Internal Medicine, Bursitis/Tendonitis of Elbow/Upper Arm Bursitis/Tendonitis of Foot/Ankle Bursitis/Tendonitis of Knee/Lower Leg Bursitis/Tendonitis of Lower Arm Bursitis/Tendonitis of Pelvic Girdle Bursitis/Tendonitis of Shoulder Family Medicine, Internal Medicine, Cardiac Congenital Disorder Cardiology Cardiac Infection Cardiology, Infectious Disease Cardiomyopathy Pulmonology Carpal Tunnel Syndrome Family Medicine, Internal Medicine, Neurology, CHF (Congestive Heart Failure) Cardiology, Pulmonology Chronic Renal Failure Nephrology Chronic Renal Inflammation Nephrology Chronic Sinusitis Allergy, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology Chronic Skin Ulcer Infectious Disease Congenital And Acquired ENT (Ears, Nose and Throat) Anomaly Congenital Disorder of CNS (Central Nervous System) Congenital Disorder of Peripheral Nerve Pulmonology Neurology Neurology Conjunctivitis Allergy, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics Contact Dermatitis Allergy, Family Medicine, Internal Medicine, Pediatrics Contraceptive Management Family Medicine, Internal Medicine, Contraceptive Management with Surgery COPD (Chronic Obstructive Pulmonary Disease) Allergy, Cardiology, Family Medicine, Internal Medicine, Pulmonology CVA (Cerebral Vascular Accident) Cardiology, Neurology Cystic Fibrosis Pulmonology 2

3 Dermatological Signs and Symptoms Allergy, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics Diabetes Cardiology, Endocrinology, Family Medicine, Infectious Disease, Internal Medicine, Nephrology, Neurology, Pulmonology, Disseminated TB (Tuberculosis) Infectious Disease Disseminated Sexually Transmitted Disease Infectious Disease, Diverticulitis Internal Medicine Endometriosis Endometriosis with Surgery Environmental Trauma Allergy, Family Medicine, Internal Medicine, Pediatrics, Pulmonology Epilepsy Neurology Exposure to Infectious Disease Infectious Disease, External Eye Infection except Conjunctivitis Family Medicine, Infectious Disease, Internal Medicine, Pediatrics Eye Trauma Family Medicine, Pediatrics Female Sex Gland Disorder Endocrinology, Fungal Skin Infection Family Medicine, Infectious Disease, Internal Medicine, Pediatrics Fungal/Other Pneumonia Infectious Disease, Pulmonology Gastritis: Duodenitis Family Medicine, Internal Medicine, Pediatrics Gout Family Medicine, Internal Medicine, Nephrology, Hearing Disorder Neurology HIV Sero-Positive without AIDS Infectious Disease Hyper-Functioning Adrenal Gland Endocrinology, Nephrology Hyper-Functioning Parathyroid Gland Endocrinology Hyper-Functioning Thyroid Gland Cardiology, Endocrinology, Internal Medicine Hyperlipidemia Cardiology, Endocrinology, Family Medicine, Infectious Disease, Internal Medicine, Nephrology,, Pulmonology, Hypertension Cardiology, Endocrinology, Family Medicine, Infectious Disease, Internal Medicine, Nephrology, Neurology,, Pulmonology, Hypo-Functioning Adrenal Gland Endocrinology 3

4 Hypo-Functioning Parathyroid Gland Endocrinology Hypo-Functioning Thyroid Gland Cardiology, Endocrinology, Family Medicine, Internal Medicine, Neurology,, Pulmonology, Immunodeficiencies Allergy, Infectious Disease, Nephrology, Induced Abortion Infection of Oral Cavity Family Medicine, Infectious Disease, Internal Medicine, Pediatrics Infection of the Cervix Infection of the Lower GU (Genitourinary) System, Not Sexually Transmitted Family Medicine, Infectious Disease, Internal Medicine, Nephrology,, Pediatrics Infection of the Ovary/Fallopian Tubes Infectious Disease, Infection of the Ovary/Fallopian Tubes with Surgery Infection of the Rectum/Anus Infectious Disease Infection of the Stomach & Esophagus Infection of the Vagina, except Momilial Infection of Upper GU (Genitourinary) System Infectious Disease, Signs And Symptoms Family Medicine, Pediatrics Family Medicine, Infectious Disease, Internal Medicine, Obstetrics and Gynecology, Pediatrics Infectious Disease, Nephrology Family Medicine, Internal Medicine, Pediatrics Infectious Hepatitis Infectious Disease Infertility Conditions Endocrinology, Infertility Conditions with Surgery Inflammation of CNS (Central Nervous System) Neurology Inflammation of Cranial Nerves Neurology Inflammation of Oral Cavity Pediatrics Inflammation of the Stomach & Esophagus Cardiology, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology, Inflammatory Eye Disease Neurology, Iron Deficiency Anemia Internal Medicine Irritable Bowel Syndrome Family Medicine, Internal Medicine, Pediatrics Ischemic Heart Disease Cardiology, Family Medicine, Internal Medicine, Pulmonology Joint Degeneration -Unspecified Family Medicine, Internal Medicine, 4

5 Joint Degeneration of Back Family Medicine, Internal Medicine, Neurology, Joint Degeneration of Foot/Ankle Joint Degeneration of Knee/Lower Leg Family Medicine, Internal Medicine, Joint Degeneration of Lower Arm Joint Degeneration of Neck Family Medicine, Internal Medicine, Neurology, Joint Degeneration of Pelvic Girdle Joint Degeneration of Shoulder Joint Derangement of Knee/Lower Leg Joint Derangement of Lower Arm Juvenile Rheumatoid Arthritis Kidney Stones Nephrology Lupus Nephrology, Major Joint Inflammation - Other Internal Medicine, Major Joint Inflammation - Unspecified Major Joint Inflammation of Back Family Medicine, Internal Medicine, Major Joint Inflammation of Elbow/Upper Arm Family Medicine, Internal Medicine, Major Joint Inflammation of Foot/Ankle Major Joint Inflammation of Knee/Lower Leg Major Joint Inflammation of Lower Arm Major Joint Inflammation of Pelvic Girdle Major Joint Inflammation of Shoulder Male Sex Gland Disorder Endocrinology, Family Medicine, Internal Medicine Malignant Neoplasm of the Breast Malignant Neoplasm of the Cervix Malignant Neoplasm of Thyroid Gland Endocrinology Malignant Neoplasm of Thyroid Gland with Active Management Endocrinology Malignant Pulmonary Neoplasm Pulmonology Menstrual Condition Endocrinology, Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics 5

6 Menstrual Condition with Surgery Migraine Headache Family Medicine, Internal Medicine, Neurology, Pediatrics Minor Bacterial Skin Infection Family Medicine, Infectious Disease, Internal Medicine, Pediatrics Minor Orthopedic Disorder - Unspecified Family Medicine, Internal Medicine Minor Orthopedic Disorder of Back Family Medicine, Internal Medicine, Neurology, Pediatrics, Minor Orthopedic Disorder of Foot/Ankle Minor Orthopedic Disorder of Lower Arm Family Medicine, Internal Medicine, Minor Orthopedic Disorder of Neck Family Medicine, Internal Medicine, Neurology, Minor Orthopedic Trauma of Back Family Medicine, Internal Medicine, Neurology, Minor Orthopedic Trauma of Foot/Ankle Minor Orthopedic Trauma of Knee/Lower Leg Minor Orthopedic Trauma of Lower Arm Family Medicine, Internal Medicine, Pediatrics, Family Medicine, Internal Medicine, Family Medicine, Minor Orthopedic Trauma of Neck Family Medicine, Internal Medicine, Neurology, Minor Orthopedic Trauma of Shoulder Family Medicine, Internal Medicine Monilial Infection of the Vagina Family Medicine, Multiple Sclerosis Neurology Nephrotic Syndrome Nephrology Non-Infectious Hepatitis Infectious Disease Non-Malignant Neoplasm of Adrenal Gland Non-Malignant Neoplasm of CNS (Central Nervous System) Non-Malignant Neoplasm of Pituitary Gland Non-Malignant Neoplasm of the Breast Non-Malignant Neoplasm of the Female Genital Tract Non-Malignant Neoplasm of The Prostate Endocrinology Neurology Endocrinology Endocrinology, Family Medicine, Internal Medicine, Obstetrics and Gynecology Family Medicine, Internal Medicine, Nephrology 6

7 Non-Malignant Neoplasm of the Skin Family Medicine, Internal Medicine Non-Malignant Neoplasm of Thyroid Gland Endocrinology Non-Malignant Pulmonary Neoplasm Pulmonology Non-Toxic Goiter Endocrinology, Internal Medicine Non-Viral Encephalitis Neurology Nutritional Deficiency Endocrinology, Internal Medicine, Obesity Cardiology, Endocrinology, Family Medicine, Internal Medicine, Nephrology,, Pediatrics, Pulmonology, Occupational & Environmental Pulmonary Disease Pulmonology Orthopedic Deformity of Back Orthopedic Infection - Unspecified Infectious Disease Orthopedic Infection of Foot/Ankle Infectious Disease Orthopedic Infection of Knee/Lower Leg Infectious Disease Orthopedic Infection of Lower Arm Infectious Disease Orthopedic Infection of Pelvic Girdle Infectious Disease Osteoporosis Endocrinology, Family Medicine, Internal Medicine, Nephrology,, Other Conduction Disorder Cardiology, Family Medicine, Internal Medicine Other Disease of the Female Genital Tract Other Disease of the Rectum or Anus Internal Medicine Other Disorder of the Breast Other Hereditary/Degenerative CNS (Central Nervous System) Other Infectious Disease of Intestine/Abdomen Other Inflammation of Non- Cranial Nerves Other Inflammation of the Female Genital System Other Inflammation of the GU (Genitourinary) System Neurology, Pulmonology, Family Medicine, Internal Medicine, Pediatrics Family Medicine, Internal Medicine, Neurology, Nephrology 7

8 Other Inflammatory Conditions of Ear/Nose/Throat Family Medicine, Internal Medicine, Pediatrics Other Inflammatory Lung Disease Pulmonology, Other Minor Infectious Pulmonary Disease Pulmonology Other Skin Disorder Endocrinology, Family Medicine, Internal Medicine, Pediatrics Other Skin Inflammation Allergy, Family Medicine, Internal Medicine, Pediatrics Otitis Media Allergy, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology Otolaryngology Disease Signs And Symptoms Family Medicine, Internal Medicine, Pediatrics Parkinson s Disease Neurology Poisoning & Toxic Drug Effects Allergy Pregnancy with Delivery Pregnancy with Delivery with CSection Primary Sexually Transmitted Disease Infectious Disease, Psoriasis Pulmonary Embolus Pulmonology Pulmonary Heart Disease Cardiology, Pulmonology Pulmonary TB (Tuberculosis) Infectious Disease, Pulmonology Respiratory Distress Syndrome Pulmonology Septicemia Infectious Disease Severe Ventricular Rhythm Cardiology Simple Hemorrhoids Family Medicine, Internal Medicine Spontaneous Abortion T&A (Tonsillectomy and Adenoidectomy) or Pharyngitis Trauma of Non-Cranial Nerves Neurology Urinary Incontinence Nephrology, Pediatrics Valvular Disorder Cardiology, Internal Medicine Vein Embolism & Thrombosis Pulmonology Viral Meningitis Infectious Disease Allergy, Family Medicine, Infectious Disease, Internal Medicine, Pediatrics, Pulmonology 8

9 Viral Pneumonia Family Medicine, Internal Medicine, Pediatrics Viral Skin Infection Family Medicine, Infectious Disease, Internal Medicine, Obstetrics and Gynecology, Pediatrics Visual Disturbance Neurology Important Program Information The information from the Premium physician designation program is not an endorsement of a particular physician or health care professional's suitability for the health care needs of any particular member. UnitedHealthcare does not practice medicine nor provide health care services. Physicians are solely responsible for medical judgments and treatments supplied. The quality and/or cost efficiency designation of a physician does not guarantee the quality of health care services members will receive from a doctor and does not guarantee the outcome of any health care services members will receive. Likewise, the fact that a physician may not be designated by this program does not mean that the physician does not provide quality health care services. All physicians in the UnitedHealthcare Network have met certain minimum credentialing requirements. Regardless of whether a physician has received a designation, members have access to all physicians in the UnitedHealthcare Network, as further described under the member's benefit plan. UnitedHealthcare informs members that designations are intended only as a guide when choosing a physician and should not be the sole factor in selecting a physician. As with all programs that evaluate performance based on analysis of a sample, there is a risk of error. There is a risk of error in the claims data used in the evaluation, in the calculations used in the evaluation, and in the way the program determined that an individual physician was responsible for the treatment of the patient's condition. Physicians have the opportunity to review and reconsider this data. UnitedHealthcare uses statistical testing to compare a physician s results to expected or normative results. There is a risk of error in statistical tests when applied to the data and a result based on statistical testing is not a guarantee of correct inference or classification. We inform members that it is important that they consider many factors and information from as many sources as possible when selecting a physician. We also inform our members that they may wish to discuss designations with a physician before choosing him or her, or confer with their current physician for advice on selecting other physicians. The information contained in this Episode Treatment Groups (ETG ) Description and Specialty document is subject to change. Insurance coverage provided by UnitedHealthcare Insurance Company or its affiliates. Health plan coverage provided by UnitedHealthcare of Colorado, Inc., UnitedHealthcare of Oregon, Inc., UnitedHealthcare of Texas, Inc., and UnitedHealthcare of Washington, Inc. or other affiliates. Administrative services provided by United HealthCare Services, Inc. or its affiliates. M49261A 6/12 ET United HealthCare Services, Inc.

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