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My school doesn't really use numbers in this way but let me give you an example that roughly approximates what happens at one school.
Imagine a huge staircase with numbered stairs. On interview day, the applicants are on the stair that corresponds to their LizzyM score. An applicant that is very impressive on interview might be moved up one stair or more. Most applicants are going to remain where they are.. not going up or down. Some student who do or say something absolutely terrible might be sent down 10 steps, or more. In some cases, an applicant that didn't impress the interviewers but wasn't horrible might go down a step or three.
Now where is everyone? Starting at the top of the staircase, we admit students until we max out the number we can safely admit (without becoming oversubscribed). Obviously, scores and grades still matter but those who are great on interview can jump ahead and those who bomb will be demoted to the bottom of the waitlist or outright rejected.
This is consistent with the results of a survey published by the AAMC in "Analysis in Brief".
https://www.aamc.org/download/261106/data/aibvol11_no6.pdf