James Fanning M.D.

Gender: M
Medical School: Ohio State University College Of Medicine
Graduation Year: 1993
Primary Specialty: Hematology/oncology

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted123
Total Provider Services181145
Total Medicare beneficiaries receiving the provider services711
The total charges that the provider submitted for all services$12,403,777.08
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.$2,261,154.95
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$1,771,499.95
Total Medicare Standardized Payment Amount$1,787,040.95
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File69
Total drug services, as defined from the Medicare Part B Drug ASP File173191
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.258
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$10,031,462.08
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.$1,786,435.20
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.$1,396,296.39
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.$1,398,805.02
Total number of HCPCS codes associated with medical (non-ASP) services54
Total medical (non-ASP) services7954
Total Medicare beneficiaries receiving medical (non-ASP) services711
The total charges that the provider submitted for medical services (non-ASP)$2,372,315.00
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.$474,719.75
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$375,203.56
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$388,235.93
Average age of beneficiaries74
Number of beneficiaries under the age of 6580
Number of beneficiaries between the ages of 65 and 74282
Number of beneficiaries between the ages of 75 and 84261
Number of beneficiaries over the age of 8488
Number of Female beneficiaries396
Number of Male Beneficiaries315
Number of Non-Hispanic White Beneficiaries635
Number of Black or African American Beneficiaries37
Number of Hispanic Beneficiaries21
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 year614
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 benefits97
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma6%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer46%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure25%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease42%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease26%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression24%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes35%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia47%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension72%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease36%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis8%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis48%
Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders2%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke5%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries2.0918

Source: data.cms.gov

James Fanning 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 needle into vein for collection of blood sample 612 190 612 $3.0 $34.0 $2.6 1306%
Blood test, basic group of blood chemicals 349 91 349 $10.06 $190.0 $8.68 2189%
Urinalysis, manual test 15 14 15 $3.23 $24.0 $3.17 757%
Complete blood cell count (red cells, white blood cell, platelets), automated test 523 182 522 $10.66 $78.0 $9.55 817%
Complete blood cell count (red cells, white blood cell, platelets), automated test 516 134 516 $8.87 $61.0 $7.57 806%
Hydration infusion into a vein 31 minutes to 1 hour 36 24 36 $54.29 $383.0 $42.56 900%
Hydration infusion into a vein 139 37 97 $14.46 $369.0 $10.86 3398%
Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour 86 36 86 $64.98 $442.0 $50.46 876%
Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour 61 25 61 $29.28 $406.0 $22.95 1769%
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 289 102 279 $24.18 $162.0 $18.69 867%
Injection of drug or substance into a vein for therapy, diagnosis, or prevention 75 33 75 $54.02 $266.0 $38.01 700%
Injection of different drug or substance into a vein for therapy, diagnosis, or prevention 772 95 350 $21.08 $240.0 $16.49 1456%
Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle 119 17 119 $69.95 $574.0 $54.84 1047%
Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle 42 20 42 $30.93 $534.0 $24.25 2202%
Infusion of chemotherapy into a vein using push technique 33 19 33 $104.03 $572.0 $81.56 701%
Infusion of different chemotherapy drug or substance into a vein 49 18 48 $58.69 $557.0 $46.01 1211%
Infusion of chemotherapy into a vein up to 1 hour 423 106 423 $129.22 $674.0 $101.23 666%
Infusion of chemotherapy into a vein 139 40 89 $26.97 $588.0 $21.15 2781%
Infusion of different chemotherapy drug or substance into a vein up to 1 hour 142 41 134 $61.35 $593.0 $48.1 1233%
Irrigation of implanted venous access drug delivery device 122 45 122 $23.21 $243.0 $16.73 1452%
New patient office or other outpatient visit, typically 30 minutes 16 16 16 $105.1 $319.0 $73.3 435%
New patient office or other outpatient visit, typically 60 minutes 56 56 56 $202.25 $715.0 $149.43 478%
Established patient office or other outpatient visit, typically 15 minutes 412 269 412 $70.93 $219.0 $50.36 435%
Established patient office or other outpatient, visit typically 25 minutes 343 157 343 $104.53 $339.0 $76.79 441%
Established patient office or other outpatient, visit typically 40 minutes 264 123 264 $141.06 $477.0 $106.5 448%
Source: 2017 Provider CMS Charge Data