Charles Oshaughnessy M.D.

Gender: M
Medical School: University Of Toledo College Of Medicine
Graduation Year: 1976
Primary Specialty: Interventional Cardiology

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted64
Total Provider Services3293
Total Medicare beneficiaries receiving the provider services1599
The total charges that the provider submitted for all services$890,863.00
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.$336,250.97
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$248,621.22
Total Medicare Standardized Payment Amount$258,622.45
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File1
Total drug services, as defined from the Medicare Part B Drug ASP File26
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.$6,500.00
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.$4,939.16
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.$4,651.65
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.$4,844.29
Total number of HCPCS codes associated with medical (non-ASP) services63
Total medical (non-ASP) services3267
Total Medicare beneficiaries receiving medical (non-ASP) services1599
The total charges that the provider submitted for medical services (non-ASP)$884,363.00
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.$331,311.81
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$243,969.57
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$253,778.16
Average age of beneficiaries75
Number of beneficiaries under the age of 65131
Number of beneficiaries between the ages of 65 and 74625
Number of beneficiaries between the ages of 75 and 84615
Number of beneficiaries over the age of 84228
Number of Female beneficiaries682
Number of Male Beneficiaries917
Number of Non-Hispanic White Beneficiaries1468
Number of Black or African American Beneficiaries61
Number of Hispanic Beneficiaries37
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 year1482
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 benefits117
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation25%
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 Asthma8%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure30%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease39%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes41%
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 disease75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis6%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis49%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders1%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke8%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.4924

Source: data.cms.gov

Charles Oshaughnessy 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
Insertion of catheter into aorta 14 14 14 $144.62 $500.0 $113.39 441%
Radiological supervision and interpretation X-ray of abdominal aorta 23 23 23 $56.12 $175.0 $44.0 398%
Radiological supervision and interpretation of imaging of arteries of both arms or legs 22 22 22 $64.19 $145.0 $50.32 288%
Pneumococcal vaccine for injection into muscle 26 26 26 $189.97 $250.0 $178.91 140%
Balloon dilation of narrowed or blocked major coronary artery or branch (accessed through the skin) 12 12 12 $500.35 $1382.0 $392.27 352%
Catheter insertion of stents in major coronary artery or branch, accessed through the skin 94 75 81 $555.83 $1535.0 $431.43 356%
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 11 11 11 $551.98 $1535.0 $432.75 355%
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel during heart attack, accessed through the skin 12 12 12 $682.94 $1720.0 $503.46 342%
Routine EKG using at least 12 leads including interpretation and report 157 145 157 $16.37 $60.0 $11.73 512%
Exercise or drug-induced heart and blood vessel stress test with EKG monitoring and physician supervision 118 118 118 $22.14 $90.0 $16.08 560%
Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report 37 37 37 $14.75 $60.0 $11.56 519%
Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report 11 11 11 $14.75 $60.0 $10.51 571%
Heart rhythm tracing, analysis, and interpretation of 48-hour EKG 29 28 29 $80.12 $550.0 $60.37 911%
Insertion of catheter for imaging of heart blood vessels or grafts 18 17 18 $212.64 $900.0 $166.7 540%
Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart 193 186 193 $255.78 $1100.0 $200.09 550%
Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart 48 40 47 $248.15 $1500.0 $192.15 781%
Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes 324 283 324 $12.32 $95.0 $9.61 988%
New patient office or other outpatient visit, typically 30 minutes 56 56 56 $105.1 $150.0 $71.79 209%
Established patient office or other outpatient visit, typically 10 minutes 59 52 59 $42.05 $65.0 $28.36 229%
Established patient office or other outpatient visit, typically 15 minutes 1763 1244 1763 $70.93 $100.0 $48.63 206%
Established patient office or other outpatient, visit typically 25 minutes 101 98 101 $104.53 $150.0 $74.64 201%
Initial hospital inpatient care, typically 70 minutes per day 15 15 15 $200.98 $300.0 $140.85 213%
Administration of pneumococcal vaccine 26 26 26 $24.25 $35.0 $22.85 153%
Source: 2017 Provider CMS Charge Data