Jennifer Kaple DNP

Gender: F
Medical School: Other
Graduation Year: 2016
Primary Specialty: Nurse Practitioner

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted32
Total Provider Services562
Total Medicare beneficiaries receiving the provider services208
The total charges that the provider submitted for all services$61,812.00
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.$34,689.04
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$27,695.72
Total Medicare Standardized Payment Amount$28,838.75
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File6
Total drug services, as defined from the Medicare Part B Drug ASP File65
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.35
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$5,103.00
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.$2,780.34
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.$2,695.06
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.$2,695.06
Total number of HCPCS codes associated with medical (non-ASP) services26
Total medical (non-ASP) services497
Total Medicare beneficiaries receiving medical (non-ASP) services208
The total charges that the provider submitted for medical services (non-ASP)$56,709.00
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.$31,908.70
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$25,000.66
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$26,143.69
Average age of beneficiaries72
Number of beneficiaries under the age of 6530
Number of beneficiaries between the ages of 65 and 74100
Number of beneficiaries between the ages of 75 and 8449
Number of beneficiaries over the age of 8429
Number of Female beneficiaries130
Number of Male Beneficiaries78
Number of Non-Hispanic White Beneficiaries190
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 year187
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 benefits21
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma10%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure9%
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 disease13%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression21%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes38%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia49%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension68%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease24%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis8%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis44%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.1492

Source: data.cms.gov

Jennifer Kaple DNP's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Removal of impact ear wax, one ear 21 20 21 $40.62 $96.0 $30.98 310%
Urinalysis, manual test 27 20 27 $3.23 $18.0 $3.17 568%
Hemoglobin A1C level 19 18 19 $13.32 $32.0 $13.05 245%
Vaccine for influenza for injection into muscle 27 27 27 $49.03 $80.0 $48.05 166%
Established patient office or other outpatient visit, typically 15 minutes 171 116 171 $60.29 $105.0 $43.66 241%
Established patient office or other outpatient, visit typically 25 minutes 122 90 122 $88.85 $157.0 $64.13 245%
Established patient office or other outpatient, visit typically 40 minutes 11 11 11 $119.9 $212.0 $79.58 266%
Administration of influenza virus vaccine 29 29 29 $24.25 $25.0 $23.76 105%
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 55 55 55 $95.85 $169.0 $93.93 180%
Source: 2017 Provider CMS Charge Data