ATTACHMENT B of CPM 2004-07
Part I. PHYSICIANS ELIGIBLE FOR PCA |
Part II. PHYSICIANS RECEIVING PCA |
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1) Total Number Employed |
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2) Number of Physicians Signing: |
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3) Average Compensation per Physician: |
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4) Average PCA Amount per Physician |
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5) Average PCA Amount per Physicians Signing: |
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6) Average PCA Amount per Physician with Federal Service of: |
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9) Number and Rate of Separations: |
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10) Number and Rate of Unfilled FTEs: |
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11) Average Length of Time (months) |
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12)What is the estimated number of physicians in FY 2004 who will be receiving PCA's in the following dollar ranges: (a) $20,000-$24,999 and (b) $25,000-$30,000?
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AGENCY/ORGANIZATION: |
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AGENCY CONTACT PERSON: |
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TELEPHONE NUMBER: |
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EMAIL ADDRESS: |
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