Linda Roeder RN, CNP

Gender: F
Medical School: Other
Graduation Year: 1997
Primary Specialty: Nurse Practitioner

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted14
Total Provider Services1390
Total Medicare beneficiaries receiving the provider services255
The total charges that the provider submitted for all services$192,487.00
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.$93,726.83
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$66,290.70
Total Medicare Standardized Payment Amount$68,543.25
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) services14
Total medical (non-ASP) services1390
Total Medicare beneficiaries receiving medical (non-ASP) services255
The total charges that the provider submitted for medical services (non-ASP)$192,487.00
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.$93,726.83
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$66,290.70
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$68,543.25
Average age of beneficiaries80
Number of beneficiaries under the age of 6533
Number of beneficiaries between the ages of 65 and 7439
Number of beneficiaries between the ages of 75 and 8472
Number of beneficiaries over the age of 84111
Number of Female beneficiaries175
Number of Male Beneficiaries80
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 year128
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 benefits127
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia50%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma7%
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 failure49%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease53%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease36%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression55%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes44%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia57%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease51%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis55%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders14%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke15%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries2.627

Source: data.cms.gov

Linda Roeder RN, CNP's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Initial nursing facility visit, typically 35 minutes per day 17 16 17 $109.3 $229.0 $80.65 284%
Subsequent nursing facility visit, typically 10 minutes per day 15 12 15 $37.31 $77.0 $21.45 359%
Subsequent nursing facility visit, typically 15 minutes per day 124 61 124 $57.71 $119.0 $43.76 272%
Subsequent nursing facility visit, typically 15 minutes per day 590 155 590 $57.71 $119.0 $38.25 311%
Subsequent nursing facility visit, typically 25 minutes per day 99 65 99 $76.37 $156.0 $57.09 273%
Subsequent nursing facility visit, typically 25 minutes per day 423 121 423 $76.37 $156.0 $56.0 279%
Nursing facility discharge management, more than 30 minutes 21 21 21 $88.81 $181.0 $66.31 273%
Nursing facility discharge management, more than 30 minutes 13 13 13 $88.81 $181.0 $69.63 260%
Established patient assisted living visit, typically 25 minutes 39 14 39 $79.63 $164.0 $58.78 279%
Source: 2017 Provider CMS Charge Data