It has 404 questions. PEER VIII is 100x's better. I'm only a resident, but I thought that PEER VIII's questions were very similar to the in-service. A lot of PEER IX's are written simply to trick you. The explanations are much better in PEER VIII. I've had multiple questions where a picture stimuli is required to answer, and no picture pops up. It appears that they are still working out the kinks. I am not too happy I spent $179 on it, and I would advise others to look elsewhere. I plan on asking for a refund or a partial refund from ACEP, because this product clearly is not ready for prime time. On top of that, it says you still will have access to PEER VIII questions with purchase, however, I have not found that to be true.