Brian Baxter D.O.

Gender: M
Medical School: Other
Graduation Year: 1989
Primary Specialty: Family Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted83
Total Provider Services3299
Total Medicare beneficiaries receiving the provider services486
The total charges that the provider submitted for all services$440,384.00
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.$224,254.65
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$155,656.76
Total Medicare Standardized Payment Amount$171,679.27
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File15
Total drug services, as defined from the Medicare Part B Drug ASP File264
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.162
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$13,884.00
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.$7,684.47
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.$7,289.05
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.$7,308.62
Total number of HCPCS codes associated with medical (non-ASP) services68
Total medical (non-ASP) services3035
Total Medicare beneficiaries receiving medical (non-ASP) services486
The total charges that the provider submitted for medical services (non-ASP)$426,500.00
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.$216,570.18
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$148,367.71
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$164,370.65
Average age of beneficiaries75
Number of beneficiaries under the age of 6546
Number of beneficiaries between the ages of 65 and 74208
Number of beneficiaries between the ages of 75 and 84135
Number of beneficiaries over the age of 8497
Number of Female beneficiaries267
Number of Male Beneficiaries219
Number of Non-Hispanic White Beneficiaries420
Number of Black or African American Beneficiaries41
Number of Hispanic Beneficiaries12
Number of American Indian/Alaska Native Beneficiaries0
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 year392
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 benefits94
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia20%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma9%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure20%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease35%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression33%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes35%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia64%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease31%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis57%
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 beneficiaries1.2871

Source: data.cms.gov

Brian Baxter 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
Removal of impact ear wax, one ear 41 35 41 $46.62 $188.63 $33.04 571%
Urinalysis, manual test 72 57 72 $3.23 $8.0 $3.17 252%
Stool analysis for blood to screen for colon tumors 28 28 28 $4.46 $11.0 $4.37 252%
Hemoglobin A1C level 45 36 45 $13.32 $27.18 $13.05 208%
Vaccine for influenza for injection into muscle 88 86 88 $48.6 $75.0 $47.63 157%
Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 13 13 13 $98.85 $159.23 $96.87 164%
Routine EKG using at least 12 leads including interpretation and report 21 21 21 $16.37 $70.0 $11.01 636%
Preparation and provision of single or multiple antigens for allergen immunotherapy 211 12 22 $12.4 $50.0 $8.95 559%
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 122 64 104 $24.25 $51.56 $17.68 292%
Established patient office or other outpatient visit, typically 15 minutes 61 56 61 $70.93 $130.0 $38.24 340%
Established patient office or other outpatient, visit typically 25 minutes 1058 358 1058 $104.53 $195.0 $63.69 306%
Established patient office or other outpatient, visit typically 40 minutes 182 123 182 $141.06 $260.0 $93.26 279%
Subsequent nursing facility visit, typically 25 minutes per day 219 78 219 $89.85 $165.0 $62.7 263%
Administration of influenza virus vaccine 94 91 94 $24.25 $44.7 $23.76 188%
Administration of pneumococcal vaccine 17 17 17 $24.25 $44.65 $23.76 188%
Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp 83 32 83 $39.96 $132.0 $30.1 438%
Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem 28 27 28 $52.19 $158.0 $40.91 386%
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 25 25 25 $167.05 $270.0 $157.16 172%
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 132 132 132 $112.77 $190.0 $108.84 175%
Annual alcohol misuse screening, 15 minutes 149 149 149 $17.36 $44.0 $17.01 259%
Annual depression screening, 15 minutes 98 98 98 $17.36 $30.0 $17.01 176%
Injection, methylprednisolone acetate, 40 mg 29 20 26 $5.87 $15.0 $4.31 348%
Injection, methylprednisolone acetate, 80 mg 45 39 44 $11.1 $40.0 $8.52 469%
Injection, lincomycin hcl, up to 300 mg 12 12 12 $12.43 $21.0 $9.74 216%
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 37 20 37 $2.82 $16.0 $1.79 896%
Source: 2017 Provider CMS Charge Data