Nancy Verhoff MD

Gender: F
Medical School: Medical College Of Ohio
Graduation Year: 2000
Primary Specialty: Family Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted46
Total Provider Services2012
Total Medicare beneficiaries receiving the provider services441
The total charges that the provider submitted for all services$224,624.00
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.$138,605.72
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$91,082.33
Total Medicare Standardized Payment Amount$100,152.96
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File9
Total drug services, as defined from the Medicare Part B Drug ASP File364
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.232
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$36,551.00
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.$18,655.87
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.$18,121.57
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.$18,239.45
Total number of HCPCS codes associated with medical (non-ASP) services37
Total medical (non-ASP) services1648
Total Medicare beneficiaries receiving medical (non-ASP) services441
The total charges that the provider submitted for medical services (non-ASP)$188,073.00
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.$119,949.85
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$72,960.76
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$81,913.51
Average age of beneficiaries75
Number of beneficiaries under the age of 6531
Number of beneficiaries between the ages of 65 and 74201
Number of beneficiaries between the ages of 75 and 84142
Number of beneficiaries over the age of 8467
Number of Female beneficiaries309
Number of Male Beneficiaries132
Number of Non-Hispanic White Beneficiaries417
Number of American Indian/Alaska Native Beneficiaries0
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 year408
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 benefits33
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia5%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma4%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer8%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure8%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression14%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes35%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia24%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension73%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease28%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis35%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke3%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries0.9779

Source: data.cms.gov

Nancy Verhoff 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
Hemoglobin A1C level 50 41 50 $13.32 $32.0 $13.05 245%
Urinalysis, manual test 42 36 42 $3.23 $7.0 $3.17 221%
Automated urinalysis test 13 13 13 $3.08 $7.0 $3.02 232%
Stool analysis for blood 36 36 36 $21.82 $45.0 $21.38 210%
Pneumococcal vaccine for injection into muscle 34 34 34 $189.92 $363.0 $186.12 195%
Vaccine for influenza for administration into muscle, 0.5 ml dosage 151 151 151 $19.03 $40.0 $18.53 216%
Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 95 95 95 $96.04 $180.0 $93.1 193%
Established patient office or other outpatient visit, typically 15 minutes 487 277 487 $70.93 $109.0 $39.55 276%
Established patient office or other outpatient, visit typically 25 minutes 634 324 634 $104.53 $159.0 $59.31 268%
Established patient office or other outpatient, visit typically 40 minutes 15 15 15 $141.06 $213.0 $90.17 236%
Administration of influenza virus vaccine 152 151 152 $24.25 $47.0 $23.76 198%
Administration of pneumococcal vaccine 128 128 128 $24.25 $47.0 $23.76 198%
Injection, triamcinolone acetonide, not otherwise specified, 10 mg 66 14 16 $1.82 $12.0 $1.26 952%
Source: 2017 Provider CMS Charge Data