Nathan Samsa D.O.

Gender: M
Medical School: Ohio University, College Of Osteopathic Medicine
Graduation Year: 2007
Primary Specialty: Pulmonary Disease

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted45
Total Provider Services1064
Total Medicare beneficiaries receiving the provider services340
The total charges that the provider submitted for all services$151,974.66
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.$116,946.40
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$85,695.90
Total Medicare Standardized Payment Amount$93,458.96
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 File39
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.11
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$524.00
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.$181.83
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.$157.83
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.$157.83
Total number of HCPCS codes associated with medical (non-ASP) services43
Total medical (non-ASP) services1025
Total Medicare beneficiaries receiving medical (non-ASP) services340
The total charges that the provider submitted for medical services (non-ASP)$151,450.66
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.$116,764.57
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$85,538.07
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$93,301.13
Average age of beneficiaries73
Number of beneficiaries under the age of 6569
Number of beneficiaries between the ages of 65 and 74124
Number of beneficiaries between the ages of 75 and 8488
Number of beneficiaries over the age of 8459
Number of Female beneficiaries176
Number of Male Beneficiaries164
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 year218
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 benefits122
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation26%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma20%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer18%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure53%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease55%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease69%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression42%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes41%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia56%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease66%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis50%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke9%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries2.5005

Source: data.cms.gov

Nathan Samsa D.O.'s 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Measurement and graphic recording of total and timed exhaled air capacity 14 14 14 $33.15 $40.0 $21.83 183%
Determination of lung volumes using gas dilution or washout 13 13 13 $12.08 $14.0 $9.28 151%
Measurement of lung diffusing capacity 13 13 13 $8.97 $14.0 $6.9 203%
New patient office or other outpatient visit, typically 45 minutes 23 23 23 $158.66 $230.04 $103.47 222%
Established patient office or other outpatient visit, typically 15 minutes 101 79 101 $69.59 $78.15 $44.85 174%
Established patient office or other outpatient, visit typically 25 minutes 113 65 113 $102.57 $119.52 $73.44 163%
Initial hospital inpatient care, typically 70 minutes per day 103 95 103 $197.39 $270.89 $150.35 180%
Subsequent hospital inpatient care, typically 15 minutes per day 13 11 13 $38.92 $68.69 $29.9 230%
Subsequent hospital inpatient care, typically 25 minutes per day 136 94 136 $70.38 $85.35 $52.25 163%
Subsequent hospital inpatient care, typically 35 minutes per day 171 109 171 $101.48 $111.75 $72.5 154%
Hospital discharge day management, 30 minutes or less 39 37 39 $70.11 $75.0 $51.11 147%
Hospital discharge day management, more than 30 minutes 16 16 16 $103.98 $135.0 $79.89 169%
Critical care delivery critically ill or injured patient, first 30-74 minutes 148 64 148 $218.71 $280.3 $165.42 169%
Source: 2017 Provider CMS Charge Data