Timothy Moore MD

Gender: M
Medical School: Wright State University Boonshoft School Of Medicine
Graduation Year: 1998
Primary Specialty: Orthopedic Surgery

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted50
Total Provider Services441
Total Medicare beneficiaries receiving the provider services139
The total charges that the provider submitted for all services$1,286,718.00
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.$177,957.21
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$138,616.62
Total Medicare Standardized Payment Amount$141,467.62
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File0
Total drug services, as defined from the Medicare Part B Drug ASP File0
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.0
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$0.00
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.$0.00
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.$0.00
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.$0.00
Total number of HCPCS codes associated with medical (non-ASP) services50
Total medical (non-ASP) services441
Total Medicare beneficiaries receiving medical (non-ASP) services139
The total charges that the provider submitted for medical services (non-ASP)$1,286,718.00
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.$177,957.21
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$138,616.62
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$141,467.62
Average age of beneficiaries68
Number of beneficiaries under the age of 6543
Number of beneficiaries between the ages of 65 and 7453
Number of beneficiaries between the ages of 75 and 8431
Number of beneficiaries over the age of 8412
Number of Female beneficiaries77
Number of Male Beneficiaries62
Number of Non-Hispanic White Beneficiaries94
Number of Black or African American Beneficiaries34
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 year94
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 benefits45
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia16%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma9%
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 failure19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression41%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes30%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia40%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension68%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis75%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.5099

Source: data.cms.gov

Timothy Moore 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
Fusion of upper spine bones, posterior or posterolateral approach 19 19 19 $802.17 $6704.0 $628.9 1066%
Fusion of spine bones, posterior or posterolateral approach 62 25 25 $402.42 $1972.0 $315.5 625%
Exploration of spinal fusion 14 13 14 $431.87 $9282.0 $338.58 2741%
Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments 24 23 23 $784.09 $9904.0 $614.72 1611%
Partial removal of bone with release of upper spinal cord or spinal nerves 12 12 12 $1258.32 $8152.0 $986.52 826%
New patient office or other outpatient visit, typically 30 minutes 17 17 17 $76.11 $196.0 $54.35 361%
New patient office or other outpatient visit, typically 30 minutes 11 11 11 $76.11 $196.0 $43.4 452%
New patient office or other outpatient visit, typically 45 minutes 11 11 11 $128.7 $244.0 $97.47 250%
Established patient office or other outpatient visit, typically 15 minutes 77 50 77 $50.5 $109.0 $35.09 311%
Established patient office or other outpatient visit, typically 15 minutes 34 30 34 $50.5 $109.0 $36.1 302%
Established patient office or other outpatient, visit typically 25 minutes 27 26 27 $77.84 $151.0 $61.02 247%
Source: 2017 Provider CMS Charge Data