Daniel Newton MD

Gender: M
Medical School: Loyola University Of Chicago, Stritch School Of Medicine
Graduation Year: 1996
Primary Specialty: Cardiovascular Disease (cardiology)

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted46
Total Provider Services1957
Total Medicare beneficiaries receiving the provider services803
The total charges that the provider submitted for all services$256,241.00
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.$143,470.97
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$108,097.13
Total Medicare Standardized Payment Amount$112,189.04
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) services46
Total medical (non-ASP) services1957
Total Medicare beneficiaries receiving medical (non-ASP) services803
The total charges that the provider submitted for medical services (non-ASP)$256,241.00
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.$143,470.97
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$108,097.13
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$112,189.04
Average age of beneficiaries76
Number of beneficiaries under the age of 6568
Number of beneficiaries between the ages of 65 and 74288
Number of beneficiaries between the ages of 75 and 84298
Number of beneficiaries over the age of 84149
Number of Female beneficiaries407
Number of Male Beneficiaries396
Number of Non-Hispanic White Beneficiaries783
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 year692
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 benefits111
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma10%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer15%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure37%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease46%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression31%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes40%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease62%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis7%
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 disorders3%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke10%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.7314

Source: data.cms.gov

Daniel Newton MD's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Catheter insertion of stents in major coronary artery or branch, accessed through the skin 50 44 46 $583.24 $1089.0 $457.26 238%
Routine EKG using at least 12 leads including interpretation and report 96 71 96 $16.35 $28.0 $11.21 250%
Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report 563 372 509 $8.44 $15.0 $6.4 234%
Exercise or drug-induced heart and blood vessel stress test with EKG monitoring and physician supervision 55 54 55 $22.14 $38.0 $17.04 223%
Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report 55 54 55 $14.75 $25.0 $11.35 220%
Heart rhythm tracing, analysis, and interpretation of 48-hour EKG 13 12 13 $26.63 $46.0 $20.87 220%
Heart rhythm tracing, computer analysis, and interpretation of patient-triggered events greater than 24-hour EKG up to 30 days 12 12 12 $26.0 $45.0 $20.38 221%
Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function 345 328 345 $63.74 $111.0 $48.96 227%
Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report 53 52 53 $70.99 $129.13 $54.6 237%
Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart 45 45 45 $310.59 $569.0 $243.5 234%
Ultrasound evaluation of heart blood vessel during diagnosis or treatment 14 13 14 $97.93 $156.0 $76.77 203%
New patient office or other outpatient visit, typically 45 minutes 35 35 35 $160.33 $283.0 $115.76 244%
Established patient office or other outpatient visit, typically 5 minutes 26 24 26 $19.34 $33.0 $13.41 246%
Established patient office or other outpatient visit, typically 15 minutes 283 173 283 $70.93 $124.0 $45.83 271%
Initial hospital inpatient care, typically 50 minutes per day 71 71 71 $135.79 $239.0 $104.96 228%
Subsequent hospital inpatient care, typically 25 minutes per day 117 61 117 $71.56 $125.0 $56.1 223%
Source: 2017 Provider CMS Charge Data