Laurie Rousseau DO

Gender: F
Medical School: Michigan State University College Of Osteopathic Medicine
Graduation Year: 2000
Primary Specialty: Family Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted56
Total Provider Services1219
Total Medicare beneficiaries receiving the provider services152
The total charges that the provider submitted for all services$115,690.00
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.$71,541.77
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$51,237.29
Total Medicare Standardized Payment Amount$53,916.01
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 File88
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.60
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$4,246.00
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.$2,413.56
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.$2,335.01
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.$2,335.01
Total number of HCPCS codes associated with medical (non-ASP) services49
Total medical (non-ASP) services1131
Total Medicare beneficiaries receiving medical (non-ASP) services152
The total charges that the provider submitted for medical services (non-ASP)$111,444.00
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.$69,128.21
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$48,902.28
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$51,581.00
Average age of beneficiaries72
Number of beneficiaries between the ages of 65 and 7494
Number of beneficiaries between the ages of 75 and 8445
Number of Female beneficiaries97
Number of Male Beneficiaries55
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation9%
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 chronic kidney disease20%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia64%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension66%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease28%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis39%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders0%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries0.8121

Source: data.cms.gov

Laurie Rousseau DO's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Insertion of needle into vein for collection of blood sample 178 109 178 $3.0 $33.0 $2.94 1122%
Urinalysis, manual test 39 29 39 $3.23 $18.0 $3.17 568%
Urine microalbumin (protein) analysis 14 14 14 $6.28 $29.0 $6.15 472%
Hemoglobin A1C level 56 34 56 $13.32 $32.0 $13.05 245%
Vaccine for influenza for injection into muscle 46 46 46 $49.03 $80.0 $48.05 166%
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 16 15 16 $24.25 $42.0 $16.3 258%
Established patient office or other outpatient visit, typically 15 minutes 134 74 134 $70.93 $105.0 $40.67 258%
Established patient office or other outpatient, visit typically 25 minutes 319 136 319 $104.53 $157.0 $61.52 255%
Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge 13 12 13 $158.47 $239.0 $124.24 192%
Administration of influenza virus vaccine 48 48 48 $24.25 $25.0 $23.76 105%
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous 19 19 19 $15.0 $15.0 $14.7 102%
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 14 14 14 $167.05 $251.0 $163.71 153%
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 95 95 95 $112.77 $169.0 $110.51 153%
Source: 2017 Provider CMS Charge Data