| Medicare Participation? | Y |
| Number of unique HCPCS codes submitted | 26 |
| Total Provider Services | 575 |
| Total Medicare beneficiaries receiving the provider services | 187 |
| The total charges that the provider submitted for all services | $53,965.00 |
| 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. | $31,478.66 |
| Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services. | $21,289.56 |
| Total Medicare Standardized Payment Amount | $22,812.09 |
| Drug Suppress Indicator - Identifies whether the utilization, cost and payment information associated with HCPCS codes for drug services as listed on the Medicare Part B Drug Average Sales Price (ASP) list have been suppressed. | * |
| Identifies whether the utilization, cost and payment information associated with HCPCS codes for Medical (non-ASP) services have been suppressed. An '*' identifies that the suppressed information is based on fewer than 11 beneficiaries and a '#' identifies that the information has been counter suppressed to prevent the re-calculation of information suppressed due to fewer than 11 beneficiaries. | # |
| Average age of beneficiaries | 72 |
| Number of beneficiaries under the age of 65 | 39 |
| Number of beneficiaries between the ages of 65 and 74 | 74 |
| Number of beneficiaries between the ages of 75 and 84 | 33 |
| Number of beneficiaries over the age of 84 | 41 |
| Number of Female beneficiaries | 127 |
| Number of Male Beneficiaries | 60 |
| 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 year | 109 |
| 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 benefits | 78 |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation | 14% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia | 26% |
| Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer | 6% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure | 20% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease | 28% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease | 18% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for depression | 31% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes | 31% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia | 42% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension | 67% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease | 26% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis | 6% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis | 48% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders | 7% |
| Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke | 11% |
| Average Hierarchical Condition Category (HCC) risk score of beneficiaries | 1.449 |
Source: data.cms.gov
Rebecca Beck CFNP's 2017 Charges to Medicare:
| Services Description | Times Provided | Beneficiaries | Beneficiaries per day | Medicare Avg. Amt. | Average Charge | Avg Medicare Payment | Percentage of Average |
|---|---|---|---|---|---|---|---|
| Automated urinalysis test | 24 | 17 | 24 | $3.08 | $15.0 | $2.9 | 516% |
| Hemoglobin A1C level | 29 | 14 | 29 | $13.32 | $55.0 | $13.05 | 421% |
| Established patient office or other outpatient visit, typically 15 minutes | 125 | 95 | 125 | $59.08 | $100.0 | $37.64 | 266% |
| Established patient office or other outpatient, visit typically 25 minutes | 111 | 63 | 111 | $87.07 | $149.0 | $55.95 | 266% |
| Subsequent nursing facility visit, typically 10 minutes per day | 131 | 45 | 131 | $36.56 | $62.0 | $25.16 | 246% |
| Subsequent nursing facility visit, typically 15 minutes per day | 70 | 37 | 70 | $56.56 | $96.0 | $34.16 | 281% |
| Nursing facility annual assessment, typically 30 minutes | 12 | 12 | 12 | $79.11 | $133.0 | $56.85 | 234% |