Robert Haladay MD

Gender: M
Medical School: State University Of New York At Stony Brook, School Of Medicine
Graduation Year: 1999
Primary Specialty: Internal Medicine

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted37
Total Provider Services10652
Total Medicare beneficiaries receiving the provider services304
The total charges that the provider submitted for all services$1,354,255.50
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.$861,390.88
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$672,582.46
Total Medicare Standardized Payment Amount$679,851.93
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File11
Total drug services, as defined from the Medicare Part B Drug ASP File8560
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.83
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$1,072,407.50
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.$720,817.55
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.$564,994.05
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.$564,994.05
Total number of HCPCS codes associated with medical (non-ASP) services26
Total medical (non-ASP) services2092
Total Medicare beneficiaries receiving medical (non-ASP) services304
The total charges that the provider submitted for medical services (non-ASP)$281,848.00
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.$140,573.33
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$107,588.41
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$114,857.88
Average age of beneficiaries71
Number of beneficiaries under the age of 6541
Number of beneficiaries between the ages of 65 and 74154
Number of beneficiaries between the ages of 75 and 8487
Number of beneficiaries over the age of 8422
Number of Female beneficiaries199
Number of Male Beneficiaries105
Number of Non-Hispanic White Beneficiaries279
Number of Black or African American Beneficiaries13
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 year253
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 benefits51
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation11%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia5%
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 cancer8%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure19%
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 depression23%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes27%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia49%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension68%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease29%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis13%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis75%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke5%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.326

Source: data.cms.gov

Robert Haladay 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
Aspiration and/or injection of large joint or joint capsule 49 38 49 $61.94 $166.53 $47.41 351%
Screening test for autoimmune disorder 33 33 33 $16.58 $38.0 $16.25 234%
Measurement of antibody for rheumatoid arthritis assessment 50 50 50 $17.76 $50.0 $16.97 295%
Measurement of DNA antibody 33 33 33 $18.85 $40.0 $18.47 217%
Measurement of antibody for assessment of autoimmune disorder 264 33 33 $24.6 $50.0 $24.11 207%
Rheumatoid factor level 58 57 58 $7.78 $18.0 $7.4 243%
Hydration infusion into a vein 31 minutes to 1 hour 151 31 151 $54.11 $100.0 $42.15 237%
Hydration infusion into a vein 175 26 109 $14.4 $50.0 $11.23 445%
Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour 68 22 68 $29.17 $50.0 $22.53 222%
Infusion of chemotherapy into a vein up to 1 hour 151 31 151 $128.79 $300.0 $98.83 304%
Infusion of chemotherapy into a vein 175 26 109 $26.85 $100.0 $21.02 476%
New patient office or other outpatient visit, typically 45 minutes 24 24 24 $160.33 $240.0 $119.02 202%
New patient office or other outpatient visit, typically 60 minutes 76 76 76 $201.72 $320.0 $153.7 208%
Established patient office or other outpatient visit, typically 15 minutes 151 113 151 $70.77 $130.0 $51.04 255%
Established patient office or other outpatient, visit typically 25 minutes 555 244 555 $104.17 $190.0 $76.49 248%
Injection, diphenhydramine hcl, up to 50 mg 69 22 69 $0.64 $1.5 $0.49 303%
Injection, infliximab, excludes biosimilar, 10 mg 3770 14 79 $85.29 $140.0 $66.86 209%
Injection, methylprednisolone sodium succinate, up to 125 mg 31 13 31 $5.77 $10.0 $4.52 221%
Injection, triamcinolone acetonide, not otherwise specified, 10 mg 238 50 65 $1.82 $8.1 $1.42 570%
Infusion, normal saline solution, 250 cc 150 30 150 $0.5 $10.0 $0.39 2539%
Injection, rituximab, 100 mg 290 11 29 $831.43 $1050.0 $651.53 161%
Source: 2017 Provider CMS Charge Data