Lauren Bailey NP-C

Gender: F
Medical School: Other
Graduation Year: 2015
Primary Specialty: Nurse Practitioner

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted16
Total Provider Services297
Total Medicare beneficiaries receiving the provider services210
The total charges that the provider submitted for all services$28,001.00
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.$13,508.04
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$7,638.11
Total Medicare Standardized Payment Amount$8,219.09
Drug Suppress Indicator - Identifies whether the utilization, cost and payment information associated with HCPCS codes for drug services as listed on the Medicare Part B Drug Average Sales Price (ASP) list have been suppressed.*
Identifies whether the utilization, cost and payment information associated with HCPCS codes for Medical (non-ASP) services have been suppressed. An '*' identifies that the suppressed information is based on fewer than 11 beneficiaries and a '#' identifies that the information has been counter suppressed to prevent the re-calculation of information suppressed due to fewer than 11 beneficiaries. #
Average age of beneficiaries69
Number of beneficiaries under the age of 6551
Number of beneficiaries between the ages of 65 and 7482
Number of beneficiaries between the ages of 75 and 8457
Number of beneficiaries over the age of 8420
Number of Female beneficiaries139
Number of Male Beneficiaries71
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 year148
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 benefits62
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia8%
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 cancer6%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease24%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease26%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia47%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension59%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis40%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.1093

Source: data.cms.gov

Lauren Bailey NP-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
Urinalysis, manual test 36 34 36 $3.23 $7.0 $3.09 227%
New patient office or other outpatient visit, typically 20 minutes 42 42 42 $61.62 $126.0 $31.89 395%
Established patient office or other outpatient visit, typically 10 minutes 32 31 32 $35.74 $74.0 $21.95 337%
Established patient office or other outpatient visit, typically 15 minutes 139 130 139 $60.29 $124.0 $32.56 381%
Source: 2017 Provider CMS Charge Data