Peter Crosby MD

Gender: M
Medical School: Other
Graduation Year: 1993
Primary Specialty: Family Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted44
Total Provider Services2552
Total Medicare beneficiaries receiving the provider services499
The total charges that the provider submitted for all services$269,206.00
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.$143,224.50
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$99,965.94
Total Medicare Standardized Payment Amount$105,216.96
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 File169
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.151
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$15,575.00
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.$9,897.05
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.$9,639.09
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.$9,688.12
Total number of HCPCS codes associated with medical (non-ASP) services37
Total medical (non-ASP) services2383
Total Medicare beneficiaries receiving medical (non-ASP) services499
The total charges that the provider submitted for medical services (non-ASP)$253,631.00
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.$133,327.45
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$90,326.85
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$95,528.84
Average age of beneficiaries73
Number of beneficiaries under the age of 6559
Number of beneficiaries between the ages of 65 and 74225
Number of beneficiaries between the ages of 75 and 84149
Number of beneficiaries over the age of 8466
Number of Female beneficiaries259
Number of Male Beneficiaries240
Number of Non-Hispanic White Beneficiaries481
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 year435
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 benefits64
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation16%
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 Asthma5%
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 heart failure18%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease21%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes38%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension69%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis5%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis44%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders3%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke5%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.2911

Source: data.cms.gov

Peter Crosby 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
Removal of impact ear wax, one ear 13 13 13 $47.79 $221.69 $28.82 769%
Urinalysis, manual test 68 54 68 $3.23 $8.0 $3.12 256%
Urine microalbumin (protein) level 36 36 36 $7.93 $14.0 $7.77 180%
Hemoglobin A1C level 325 140 325 $13.32 $26.42 $12.85 206%
Blood test, clotting time 107 32 107 $5.39 $13.0 $5.28 246%
Detection test for influenza virus 24 13 15 $16.44 $45.33 $16.11 281%
Vaccine for influenza for injection into muscle 135 135 135 $49.03 $75.0 $47.69 157%
Pneumococcal vaccine for injection into muscle 11 11 11 $188.43 $310.0 $184.66 168%
Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 11 11 11 $98.04 $160.0 $96.08 167%
Routine electrocardiogram (EKG) with tracing using at least 12 leads 13 11 13 $7.94 $40.0 $5.74 697%
Established patient office or other outpatient visit, typically 5 minutes 72 25 72 $19.34 $75.0 $14.74 509%
Established patient office or other outpatient visit, typically 15 minutes 1220 425 1220 $70.93 $130.0 $45.1 288%
Established patient office or other outpatient, visit typically 25 minutes 239 173 239 $104.53 $195.0 $72.21 270%
Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge 19 17 19 $158.47 $278.0 $118.85 234%
Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge 11 11 11 $224.33 $392.0 $175.87 223%
Administration of influenza virus vaccine 135 135 135 $24.25 $44.99 $23.58 191%
Administration of pneumococcal vaccine 22 22 22 $24.25 $44.64 $23.76 188%
Source: 2017 Provider CMS Charge Data