Billy Back MD

Gender: M
Medical School: Medical College Of Ohio
Graduation Year: 1999
Primary Specialty: Internal Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted66
Total Provider Services4390
Total Medicare beneficiaries receiving the provider services1071
The total charges that the provider submitted for all services$464,629.00
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.$225,178.03
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$156,036.17
Total Medicare Standardized Payment Amount$169,632.38
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File7
Total drug services, as defined from the Medicare Part B Drug ASP File553
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.208
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$37,755.00
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.$18,048.72
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.$17,491.46
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.$17,510.49
Total number of HCPCS codes associated with medical (non-ASP) services59
Total medical (non-ASP) services3837
Total Medicare beneficiaries receiving medical (non-ASP) services1071
The total charges that the provider submitted for medical services (non-ASP)$426,874.00
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.$207,129.31
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$138,544.71
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$152,121.89
Average age of beneficiaries73
Number of beneficiaries under the age of 65167
Number of beneficiaries between the ages of 65 and 74435
Number of beneficiaries between the ages of 75 and 84304
Number of beneficiaries over the age of 84165
Number of Female beneficiaries590
Number of Male Beneficiaries481
Number of Non-Hispanic White Beneficiaries1020
Number of Hispanic Beneficiaries31
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 year848
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 benefits223
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation14%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia12%
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 cancer10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease38%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression25%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes40%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia55%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease43%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis7%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis44%
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 stroke7%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.4837

Source: data.cms.gov

Billy Back 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
Insertion of needle into vein for collection of blood sample 52 34 52 $3.0 $8.0 $2.94 272%
Biopsy of large bowel using an endoscope 22 22 22 $180.32 $625.0 $128.2 488%
Removal of impact ear wax, one ear 11 11 11 $47.79 $86.0 $27.34 315%
Urinalysis, manual test 31 26 31 $3.23 $7.0 $3.17 221%
Stool analysis for blood 25 25 25 $21.82 $45.0 $21.38 210%
Pneumococcal vaccine for injection into muscle 55 55 55 $188.43 $363.0 $184.66 197%
Vaccine for influenza for administration into muscle, 0.5 ml dosage 169 158 169 $19.03 $40.0 $18.54 216%
Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older 41 41 41 $95.38 $180.0 $93.47 193%
Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report 1439 759 1334 $8.44 $24.25 $6.08 399%
Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration 77 77 77 $13.59 $22.1 $9.95 222%
Measurement of lung diffusing capacity 74 74 74 $9.72 $16.19 $7.3 222%
Established patient office or other outpatient visit, typically 5 minutes 15 13 15 $19.34 $30.0 $11.22 267%
Established patient office or other outpatient visit, typically 15 minutes 446 209 446 $70.93 $109.0 $41.88 260%
Established patient office or other outpatient, visit typically 25 minutes 643 274 643 $104.53 $159.0 $57.84 275%
Hospital observation care discharge 47 46 47 $71.9 $187.0 $54.21 345%
Hospital observation care typically 70 minutes per day 45 44 45 $184.14 $480.0 $137.58 349%
Initial hospital inpatient care, typically 50 minutes per day 16 16 16 $135.79 $356.13 $104.33 341%
Initial hospital inpatient care, typically 70 minutes per day 108 93 108 $193.76 $524.24 $146.39 358%
Subsequent hospital inpatient care, typically 25 minutes per day 97 59 97 $71.56 $187.09 $53.86 347%
Subsequent hospital inpatient care, typically 35 minutes per day 161 64 161 $103.48 $269.08 $79.5 338%
Hospital discharge day management, 30 minutes or less 32 29 32 $71.54 $187.0 $54.01 346%
Hospital discharge day management, more than 30 minutes 81 75 81 $106.1 $276.0 $81.14 340%
Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge 29 24 29 $158.47 $241.0 $119.94 201%
Administration of influenza virus vaccine 168 157 168 $24.25 $47.0 $23.76 198%
Administration of pneumococcal vaccine 96 96 96 $24.25 $47.0 $23.76 198%
Source: 2017 Provider CMS Charge Data