Donald Smith MD

Gender: M
Medical School: University Of Cincinnati College Of Medicine
Graduation Year: 1982
Primary Specialty: Urology

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted65
Total Provider Services3491
Total Medicare beneficiaries receiving the provider services693
The total charges that the provider submitted for all services$1,290,610.00
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.$333,572.00
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$243,556.79
Total Medicare Standardized Payment Amount$254,449.28
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File2
Total drug services, as defined from the Medicare Part B Drug ASP File206
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.23
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$112,200.00
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.$40,333.66
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.$31,406.11
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.$31,406.11
Total number of HCPCS codes associated with medical (non-ASP) services63
Total medical (non-ASP) services3285
Total Medicare beneficiaries receiving medical (non-ASP) services693
The total charges that the provider submitted for medical services (non-ASP)$1,178,410.00
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.$293,238.34
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$212,150.68
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$223,043.17
Average age of beneficiaries73
Number of beneficiaries under the age of 6582
Number of beneficiaries between the ages of 65 and 74297
Number of beneficiaries between the ages of 75 and 84214
Number of beneficiaries over the age of 84100
Number of Female beneficiaries206
Number of Male Beneficiaries487
Number of Non-Hispanic White Beneficiaries599
Number of Black or African American Beneficiaries51
Number of Beneficiaries With Race Not Elsewhere Classified25
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 year585
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 benefits108
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 dementia14%
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 cancer23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease46%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression26%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes41%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia55%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension74%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease41%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis6%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis52%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders4%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke7%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.5742

Source: data.cms.gov

Donald Smith 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
Ultrasound measurement of bladder capacity after voiding 222 137 222 $18.18 $200.0 $12.41 1612%
Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope 47 46 47 $100.78 $900.0 $76.63 1174%
Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope 96 82 96 $158.58 $900.0 $112.96 797%
Dilation of bladder canal (urethra) using an endoscope 46 46 46 $154.29 $1041.0 $118.25 880%
Dilation of bladder canal (urethra) using an endoscope 52 50 52 $258.91 $1041.0 $184.54 564%
Insertion of stent in urinary duct (ureter) using an endoscope 21 17 21 $116.96 $3071.0 $91.7 3349%
Insertion of implant material in bladder using an endoscope 12 12 12 $230.82 $700.0 $180.97 387%
Insertion of implant material in bladder using an endoscope 43 12 12 $61.56 $200.0 $48.26 414%
Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope 20 20 20 $854.69 $4000.0 $658.3 608%
Biopsy of prostate gland 13 13 13 $127.92 $795.0 $94.52 841%
Biopsy of prostate gland 11 11 11 $230.98 $795.0 $181.09 439%
Ultrasound of rectum 12 12 12 $33.39 $259.0 $24.72 1048%
Ultrasound of rectum 12 12 12 $81.46 $259.0 $63.86 406%
Automated urinalysis test 920 503 917 $3.08 $15.0 $2.98 503%
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 33 13 33 $24.25 $30.0 $15.5 194%
Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle 28 17 28 $30.93 $90.0 $20.84 432%
New patient office or other outpatient visit, typically 30 minutes 24 24 24 $105.1 $200.0 $65.69 304%
New patient office or other outpatient visit, typically 45 minutes 154 154 154 $160.33 $250.0 $105.77 236%
Established patient office or other outpatient visit, typically 5 minutes 18 15 18 $19.34 $45.0 $15.16 297%
Established patient office or other outpatient visit, typically 15 minutes 382 298 382 $70.93 $145.0 $49.94 290%
Established patient office or other outpatient, visit typically 25 minutes 19 19 19 $77.84 $195.0 $61.02 320%
Established patient office or other outpatient, visit typically 25 minutes 654 345 654 $104.53 $195.0 $72.25 270%
Established patient office or other outpatient, visit typically 40 minutes 99 83 99 $141.06 $260.0 $98.56 264%
Initial hospital inpatient care, typically 50 minutes per day 68 66 68 $135.79 $400.0 $98.33 407%
Leuprolide acetate (for depot suspension), 7.5 mg 168 17 28 $211.03 $600.0 $164.62 364%
Source: 2017 Provider CMS Charge Data