Cassandra Case NP-C

Gender: F
Medical School: Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University
Graduation Year: 2014
Primary Specialty: Nurse Practitioner

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted41
Total Provider Services984
Total Medicare beneficiaries receiving the provider services195
The total charges that the provider submitted for all services$118,415.00
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.$54,659.57
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$37,226.85
Total Medicare Standardized Payment Amount$40,709.42
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File8
Total drug services, as defined from the Medicare Part B Drug ASP File98
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.61
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$6,196.00
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.$3,613.66
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.$3,520.80
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.$3,520.80
Total number of HCPCS codes associated with medical (non-ASP) services33
Total medical (non-ASP) services886
Total Medicare beneficiaries receiving medical (non-ASP) services195
The total charges that the provider submitted for medical services (non-ASP)$112,219.00
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.$51,045.91
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$33,706.05
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$37,188.62
Average age of beneficiaries70
Number of beneficiaries under the age of 6528
Number of beneficiaries between the ages of 65 and 7496
Number of beneficiaries between the ages of 75 and 8457
Number of beneficiaries over the age of 8414
Number of Female beneficiaries116
Number of Male Beneficiaries79
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 year166
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 benefits29
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation9%
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 cancer13%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease19%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia70%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension67%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis10%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis46%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.008

Source: data.cms.gov

Cassandra Case NP-C's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Administration of influenza virus vaccine 53 51 53 $24.25 $44.92 $23.76 189%
Urinalysis, manual test 29 23 29 $3.23 $8.0 $3.09 259%
Urine microalbumin (protein) level 16 16 16 $7.93 $14.0 $7.28 192%
Hemoglobin A1C level 51 29 51 $13.32 $25.76 $12.79 201%
Vaccine for influenza for injection into muscle 47 46 47 $48.9 $75.0 $47.92 157%
Established patient office or other outpatient visit, typically 15 minutes 198 119 198 $60.29 $130.0 $35.22 369%
Established patient office or other outpatient, visit typically 25 minutes 256 129 256 $88.85 $195.0 $49.33 395%
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 52 52 52 $95.85 $190.0 $93.93 202%
Annual alcohol misuse screening, 15 minutes 48 48 48 $14.76 $44.0 $14.46 304%
Annual depression screening, 15 minutes 46 46 46 $14.76 $30.0 $14.46 207%
Source: 2017 Provider CMS Charge Data