Paul Biedenbach D.O.

Gender: M
Medical School: Ohio University, College Of Osteopathic Medicine
Graduation Year: 1992
Primary Specialty: Otolaryngology

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted105
Total Provider Services1622
Total Medicare beneficiaries receiving the provider services498
The total charges that the provider submitted for all services$613,755.00
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.$196,947.02
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$144,783.12
Total Medicare Standardized Payment Amount$154,075.36
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) services105
Total medical (non-ASP) services1622
Total Medicare beneficiaries receiving medical (non-ASP) services498
The total charges that the provider submitted for medical services (non-ASP)$613,755.00
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.$196,947.02
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$144,783.12
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$154,075.36
Average age of beneficiaries72
Number of beneficiaries under the age of 6586
Number of beneficiaries between the ages of 65 and 74190
Number of beneficiaries between the ages of 75 and 84153
Number of beneficiaries over the age of 8469
Number of Female beneficiaries269
Number of Male Beneficiaries229
Number of Non-Hispanic White Beneficiaries462
Number of Black or African American Beneficiaries24
Number of Asian Pacific Islander Beneficiaries0
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 year406
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 benefits92
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation16%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia10%
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 cancer14%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure18%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease31%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease21%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression24%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia50%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension69%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis52%
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 stroke5%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.4073

Source: data.cms.gov

Paul Biedenbach 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
Fine needle aspiration using imaging guidance 31 12 12 $135.9 $545.0 $106.55 512%
Complex control of nose bleed 55 29 55 $213.33 $860.36 $167.26 514%
Diagnostic examination of nasal passages using an endoscope 58 51 58 $171.3 $800.0 $134.0 597%
Diagnostic examination of voice box using flexible endoscope 56 44 56 $109.56 $439.43 $85.9 512%
Removal of impact ear wax, one ear 109 66 109 $43.63 $188.59 $31.13 606%
Removal of skin debris and drainage of mastoid cavity 32 11 32 $89.85 $480.53 $50.05 960%
Ultrasound of head and neck 44 37 44 $110.81 $390.45 $76.22 512%
New patient office or other outpatient visit, typically 30 minutes 30 30 30 $105.1 $195.0 $79.31 246%
New patient office or other outpatient visit, typically 45 minutes 180 180 180 $160.33 $295.0 $111.13 265%
New patient office or other outpatient visit, typically 60 minutes 25 25 25 $202.25 $375.0 $156.56 240%
Established patient office or other outpatient visit, typically 15 minutes 134 91 134 $70.93 $130.0 $50.6 257%
Established patient office or other outpatient, visit typically 25 minutes 477 268 477 $104.53 $195.0 $73.89 264%
Established patient office or other outpatient, visit typically 40 minutes 59 53 59 $141.06 $260.0 $103.42 251%
Initial hospital inpatient care, typically 50 minutes per day 18 18 18 $135.79 $250.0 $102.85 243%
Source: 2017 Provider CMS Charge Data