Kari Ketvertis MD

Gender: F
Medical School: University Of Cincinnati College Of Medicine
Graduation Year: 1999
Primary Specialty: Family Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted57
Total Provider Services1197
Total Medicare beneficiaries receiving the provider services252
The total charges that the provider submitted for all services$132,381.99
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.$71,349.38
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$52,073.59
Total Medicare Standardized Payment Amount$56,525.02
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File11
Total drug services, as defined from the Medicare Part B Drug ASP File257
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.82
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$13,145.61
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.$7,529.59
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.$6,948.01
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.$6,948.01
Total number of HCPCS codes associated with medical (non-ASP) services46
Total medical (non-ASP) services940
Total Medicare beneficiaries receiving medical (non-ASP) services252
The total charges that the provider submitted for medical services (non-ASP)$119,236.38
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.$63,819.79
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$45,125.58
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$49,577.01
Average age of beneficiaries69
Number of beneficiaries under the age of 6561
Number of beneficiaries between the ages of 65 and 74124
Number of beneficiaries between the ages of 75 and 8451
Number of beneficiaries over the age of 8416
Number of Female beneficiaries188
Number of Male Beneficiaries64
Number of Non-Hispanic White Beneficiaries210
Number of Black or African American Beneficiaries30
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 year165
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 benefits87
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 dementia9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma8%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease34%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease21%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression25%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes42%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia64%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis49%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders5%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke8%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.3201

Source: data.cms.gov

Kari Ketvertis MD'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 24 18 24 $3.23 $8.0 $3.17 252%
Automated urinalysis test 14 14 14 $3.08 $14.95 $3.02 495%
Urine microalbumin (protein) level 11 11 11 $7.93 $14.0 $7.77 180%
Hemoglobin A1C level 84 65 84 $13.32 $40.57 $13.05 311%
Administration of 1 vaccine 19 19 19 $23.79 $30.9 $17.3 179%
Vaccine for influenza for injection into muscle 58 57 58 $48.7 $75.0 $47.73 157%
Pneumococcal vaccine for injection into muscle 12 12 12 $184.96 $298.33 $181.27 165%
Routine EKG using at least 12 leads including interpretation and report 13 13 13 $16.29 $72.42 $10.74 674%
Established patient office or other outpatient visit, typically 15 minutes 231 108 231 $70.93 $130.0 $42.65 305%
Established patient office or other outpatient, visit typically 25 minutes 237 115 237 $104.53 $195.0 $63.34 308%
Administration of influenza virus vaccine 59 58 59 $24.25 $44.9 $23.76 189%
Administration of pneumococcal vaccine 15 15 15 $24.25 $43.8 $23.76 184%
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 104 104 104 $112.75 $189.28 $110.47 171%
Source: 2017 Provider CMS Charge Data