James Kasten M.D.

Gender: M
Medical School: Ohio State University College Of Medicine
Graduation Year: 1982
Primary Specialty: Obstetrics/gynecology

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted33
Total Provider Services1734
Total Medicare beneficiaries receiving the provider services128
The total charges that the provider submitted for all services$100,708.40
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.$51,695.87
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$42,662.82
Total Medicare Standardized Payment Amount$41,513.87
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 File1421
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.26
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$29,490.40
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.$24,045.79
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.$18,692.13
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.$18,692.13
Total number of HCPCS codes associated with medical (non-ASP) services30
Total medical (non-ASP) services313
Total Medicare beneficiaries receiving medical (non-ASP) services128
The total charges that the provider submitted for medical services (non-ASP)$71,218.00
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.$27,650.08
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$23,970.69
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$22,821.74
Average age of beneficiaries66
Number of beneficiaries between the ages of 65 and 7457
Number of beneficiaries between the ages of 75 and 8431
Number of Female beneficiaries128
Number of Male 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 year97
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 benefits31
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease15%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes16%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia38%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension52%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis50%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries0.9408

Source: data.cms.gov

James Kasten 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
Urinalysis, manual test 23 19 23 $3.23 $20.0 $3.17 631%
Stool analysis for blood to screen for colon tumors 49 49 49 $4.46 $5.0 $4.37 114%
Detection test for candida species (yeast) 13 11 13 $27.51 $60.0 $25.03 240%
Detection test for gardnerella vaginalis (bacteria) 13 11 13 $27.51 $60.0 $25.03 240%
Detection test for Trichomonas vaginalis (genital parasite) 13 11 13 $27.51 $60.0 $25.03 240%
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 25 19 25 $23.52 $25.0 $20.45 122%
Established patient office or other outpatient visit, typically 15 minutes 67 42 67 $68.8 $125.0 $47.64 262%
Cervical or vaginal cancer screening; pelvic and clinical breast examination 32 32 32 $36.26 $45.0 $41.03 110%
Injection, denosumab, 1 mg 1380 17 23 $16.98 $18.33 $13.29 138%
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 17 17 17 $41.76 $50.0 $47.26 106%
Source: 2017 Provider CMS Charge Data