Deborah Sommers PA-C

Gender: F
Medical School: Other
Graduation Year: 1996
Primary Specialty: Physician Assistant

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted29
Total Provider Services267
Total Medicare beneficiaries receiving the provider services79
The total charges that the provider submitted for all services$35,418.00
The Medicare allowed amount for all provider services. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$17,676.91
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$11,714.62
Total Medicare Standardized Payment Amount$12,198.44
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File7
Total drug services, as defined from the Medicare Part B Drug ASP File38
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.17
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$2,896.00
The Medicare allowed amount for drug services, as defined from the Medicare Part B Drug ASP File. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$1,795.07
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item drug services, as defined from the Medicare Part B Drug ASP File.$1,753.17
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item drug service , as defined from the Medicare Part B Drug ASP File and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care.$1,753.17
Total number of HCPCS codes associated with medical (non-ASP) services22
Total medical (non-ASP) services229
Total Medicare beneficiaries receiving medical (non-ASP) services79
The total charges that the provider submitted for medical services (non-ASP)$32,522.00
The Medicare allowed amount for medical (non-ASP) services. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$15,881.84
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$9,961.45
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item medical (non-ASP) service , as defined from the Medicare Part B Drug ASP File and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care$10,445.27
Average age of beneficiaries69
Number of beneficiaries between the ages of 65 and 7440
Number of beneficiaries between the ages of 75 and 8418
Number of Female beneficiaries58
Number of Male Beneficiaries21
Number of Medicare beneficiaries qualified to receive Medicare only benefits. Beneficiaries are classified as Medicare only entitlement if they received zero months of any Medicaid benefits (full or partial) in the given calendar year64
Number of Medicare beneficiaries qualified to receive Medicare and Medicaid benefits. Beneficiaries are classified as Medicare and Medicaid entitlement if in any month in the given calendar year they were receiving full or partial Medicaid benefits15
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression20%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes30%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia33%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension66%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease20%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis38%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries0.9644

Source: data.cms.gov

Deborah Sommers PA-C's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Vaccine for influenza for injection into muscle 11 11 11 $49.03 $64.0 $48.05 133%
Established patient office or other outpatient visit, typically 15 minutes 48 32 48 $60.29 $124.0 $37.55 330%
Established patient office or other outpatient, visit typically 25 minutes 92 60 92 $88.85 $183.0 $47.31 387%
Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge 15 11 15 $190.68 $392.0 $149.49 262%
Administration of influenza virus vaccine 14 14 14 $24.25 $42.0 $23.76 177%
Source: 2017 Provider CMS Charge Data