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Of the 158 employees, 49 are sales and marketing, and 44 are general and administrative personnel, 6 are in manufacturing, 15 in quality control and assurance, and 44 are in research and development. For example, there is a PTP edit on an E/M service (eg, code 99213) and a non-E/M service (eg, code 96372). The authors noted that “two other studies could not replicate these findings for other health conditions.”  assuming that the following unquantified factors “probably serve as counterweights to one another”: (1) all costs of defensive medicine that were not eliminated by the legal reforms in the study they extrapolated (2) physicians’ perceptions that Medicare patients may be less likely to sue or to receive large payouts because they are older than the general population (3) physicians’ perceptions that the threat of liability with cardiac patients may be greater than with other patients. (4) physicians’ perceptions that the threat of liability with Medicare patients may be greater “because higher levels of managed care outside of Medicare reduce physicians’ discretion.”  The authors arrived at the $6.8 billion estimate for physician/clinical services by assuming that the cost of malpractice payments are equivalent to the costs of defensive medicine.  (Defensive medicine does not involve the costs of malpractice payments but the costs of medically unnecessary actions that healthcare providers take to prevent from having to make such payments.  ) The authors did not account for defensive medicine costs outside of hospitals and physician/clinical services,  which accounted for 50% of U.