National Provider Identifier [NPI]: |
1124163407 |
Last Name Of The Provider |
BAR-LEV |
First Name Of The Provider |
AVI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 E GRANT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
APPLETON |
Zip Code Of The Provider |
549113487 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
164 |
Number Of Services |
114035 |
Number Of Medicare Beneficiaries |
462 |
Total Submitted Charge Amount |
4510535.23 |
Total Medicare Allowed Amount |
1673413.35 |
Total Medicare Payment Amount |
1313577.37 |
Total Medicare Standardized Payment Amount |
1315522.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
71 |
Number Of Drug Services |
104238 |
Number Of Medicare Beneficiaries With Drug Services |
148 |
Total Drug Submitted ChargeAmount |
3286897.8 |
Total Drug Medicare AllowedAmount |
1432274.65 |
Total Drug Medicare PaymentAmount |
1122320.82 |
Total Drug Medicare Standardized Payment Amount |
1122320.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
93 |
Number Of Medical Services |
9797 |
Number Of Medicare Beneficiaries With Medical Services |
462 |
Total Medical Submitted Charge Amount |
1223637.43 |
Total Medical Medicare Allowed Amount |
241138.7 |
Total Medical Medicare Payment Amount |
191256.55 |
Total Medical Medicare Standardized Payment Amount |
193201.83 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
447 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
387 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
41 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.0186 |