Elyse Tinker D.O.

Gender: F
Medical School: Ohio University, College Of Osteopathic Medicine
Graduation Year: 2013
Primary Specialty: Family Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted31
Total Provider Services306
Total Medicare beneficiaries receiving the provider services151
The total charges that the provider submitted for all services$37,377.00
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.$21,729.11
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$16,211.07
Total Medicare Standardized Payment Amount$16,537.46
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File3
Total drug services, as defined from the Medicare Part B Drug ASP File15
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.14
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$1,247.00
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.$972.71
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.$953.27
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.$953.27
Total number of HCPCS codes associated with medical (non-ASP) services28
Total medical (non-ASP) services291
Total Medicare beneficiaries receiving medical (non-ASP) services151
The total charges that the provider submitted for medical services (non-ASP)$36,130.00
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.$20,756.40
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$15,257.80
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$15,584.19
Average age of beneficiaries66
Number of beneficiaries under the age of 6549
Number of beneficiaries between the ages of 65 and 7457
Number of beneficiaries between the ages of 75 and 8429
Number of beneficiaries over the age of 8416
Number of Female beneficiaries96
Number of Male Beneficiaries55
Number of Non-Hispanic White Beneficiaries108
Number of Hispanic Beneficiaries24
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 year80
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 benefits71
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation14%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease31%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease15%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression28%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes37%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia53%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension65%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis42%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders9%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.6037

Source: data.cms.gov

Elyse Tinker 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
Automated urinalysis test 19 16 19 $3.08 $15.0 $3.02 497%
Vaccine for influenza for injection into muscle 11 11 11 $49.03 $55.0 $48.05 114%
New patient office or other outpatient visit, typically 30 minutes 13 13 13 $105.1 $149.0 $72.94 204%
Established patient office or other outpatient visit, typically 15 minutes 51 44 51 $55.06 $136.0 $30.47 446%
Established patient office or other outpatient visit, typically 15 minutes 52 44 52 $71.34 $103.92 $53.91 193%
Established patient office or other outpatient, visit typically 25 minutes 78 49 78 $104.53 $149.0 $81.58 183%
Administration of influenza virus vaccine 14 14 14 $24.25 $35.0 $23.76 147%
Source: 2017 Provider CMS Charge Data