Amanda Horn NP-C

Gender: F
Medical School: University Of Cincinnati College Of Medicine
Graduation Year: 2014
Primary Specialty: Nurse Practitioner

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted44
Total Provider Services715
Total Medicare beneficiaries receiving the provider services216
The total charges that the provider submitted for all services$68,431.00
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.$34,122.68
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$23,685.27
Total Medicare Standardized Payment Amount$24,912.85
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 File118
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.45
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$8,507.00
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.$4,885.94
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.$4,759.26
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.$4,759.28
Total number of HCPCS codes associated with medical (non-ASP) services35
Total medical (non-ASP) services597
Total Medicare beneficiaries receiving medical (non-ASP) services216
The total charges that the provider submitted for medical services (non-ASP)$59,924.00
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.$29,236.74
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$18,926.01
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$20,153.57
Average age of beneficiaries70
Number of beneficiaries under the age of 6536
Number of beneficiaries between the ages of 65 and 74115
Number of beneficiaries between the ages of 75 and 8446
Number of beneficiaries over the age of 8419
Number of Female beneficiaries138
Number of Male Beneficiaries78
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 year188
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 benefits28
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation13%
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 Asthma6%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer13%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease26%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease21%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia54%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension65%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease25%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis47%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.0531

Source: data.cms.gov

Amanda Horn NP-C'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 91 66 91 $3.0 $6.0 $2.92 205%
Automated urinalysis test 26 25 26 $3.08 $7.0 $2.9 241%
Urine microalbumin (protein) analysis 12 12 12 $6.28 $13.0 $5.68 229%
Pneumococcal vaccine for injection into muscle 19 19 19 $187.15 $308.0 $183.41 168%
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 24 17 23 $20.61 $42.0 $12.68 331%
Established patient office or other outpatient visit, typically 15 minutes 207 137 207 $60.29 $124.0 $33.43 371%
Established patient office or other outpatient, visit typically 25 minutes 87 66 87 $88.85 $183.0 $57.44 319%
Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge 15 14 15 $134.7 $277.0 $102.61 270%
Administration of influenza virus vaccine 22 21 22 $24.25 $42.0 $23.76 177%
Administration of pneumococcal vaccine 27 27 27 $24.25 $42.0 $23.76 177%
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) 13 12 13 $12.04 $25.0 $11.8 212%
Source: 2017 Provider CMS Charge Data