Zachary Zumbar M.D.

Gender: M
Medical School: Ohio State University College Of Medicine
Graduation Year: 2006
Primary Specialty: Pain Management

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted49
Total Provider Services2927
Total Medicare beneficiaries receiving the provider services514
The total charges that the provider submitted for all services$357,608.89
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.$215,142.27
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$152,534.78
Total Medicare Standardized Payment Amount$168,214.78
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File0
Total drug services, as defined from the Medicare Part B Drug ASP File0
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.0
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$0.00
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.$0.00
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.$0.00
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.$0.00
Total number of HCPCS codes associated with medical (non-ASP) services49
Total medical (non-ASP) services2927
Total Medicare beneficiaries receiving medical (non-ASP) services514
The total charges that the provider submitted for medical services (non-ASP)$357,608.89
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.$215,142.27
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$152,534.78
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$168,214.78
Average age of beneficiaries71
Number of beneficiaries under the age of 65122
Number of beneficiaries between the ages of 65 and 74187
Number of beneficiaries between the ages of 75 and 84143
Number of beneficiaries over the age of 8462
Number of Female beneficiaries326
Number of Male Beneficiaries188
Number of Non-Hispanic White Beneficiaries478
Number of Black or African American Beneficiaries11
Number of Beneficiaries With Race Not Elsewhere Classified14
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 year400
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 benefits114
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma11%
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 failure15%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease33%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease26%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression34%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes37%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia54%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease39%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis75%
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 stroke4%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.4099

Source: data.cms.gov

Zachary Zumbar M.D.'s 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Injections of trigger points in 1 or 2 muscles 25 19 25 $36.55 $58.24 $25.7 227%
Aspiration and/or injection of large joint or joint capsule 142 78 141 $49.57 $84.0 $34.19 246%
Injection procedure into sacroiliac joint for anesthetic or steroid 121 96 121 $101.77 $253.33 $76.28 332%
Injection of substance into spinal canal of upper or middle back using imaging guidance 20 16 20 $108.65 $167.0 $72.53 230%
Injection of substance into spinal canal of lower back or sacrum using imaging guidance 109 76 109 $99.07 $156.94 $69.89 225%
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance 181 118 181 $127.39 $174.96 $91.73 191%
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance 110 65 95 $53.77 $80.39 $40.12 200%
Injections of upper or middle spine facet joint using imaging guidance 41 27 41 $130.86 $192.88 $92.87 208%
Injections of upper or middle spine facet joint using imaging guidance 38 26 38 $74.37 $105.38 $53.79 196%
Injections of upper or middle spine facet joint using imaging guidance 35 25 35 $74.74 $106.88 $53.85 198%
Injections of lower or sacral spine facet joint using imaging guidance 81 58 81 $118.54 $167.8 $87.52 192%
Injections of lower or sacral spine facet joint using imaging guidance 75 54 75 $68.66 $153.84 $51.18 301%
Injections of lower or sacral spine facet joint using imaging guidance 73 52 73 $69.31 $154.99 $52.16 297%
Destruction of lower or sacral spinal facet joint nerves using imaging guidance 40 33 40 $264.02 $328.7 $188.58 174%
Destruction of lower or sacral spinal facet joint nerves with imaging guidance 72 31 38 $71.88 $181.11 $51.6 351%
Fluoroscopic guidance for insertion of needle 18 15 18 $40.64 $89.0 $28.29 315%
New patient office or other outpatient visit, typically 30 minutes 44 44 44 $74.59 $117.5 $52.95 222%
New patient office or other outpatient visit, typically 45 minutes 92 92 92 $126.13 $175.22 $86.07 204%
Established patient office or other outpatient visit, typically 15 minutes 1386 429 1386 $49.49 $82.15 $34.04 241%
Established patient office or other outpatient, visit typically 25 minutes 50 43 50 $76.28 $121.4 $55.11 220%
Source: 2017 Provider CMS Charge Data