National Provider Identifier [NPI]: |
1760442214 |
Last Name Of The Provider |
RUNDE |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
206 N PEARL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEUTOPOLIS |
Zip Code Of The Provider |
624671134 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
975 |
Number Of Medicare Beneficiaries |
333 |
Total Submitted Charge Amount |
96801.2 |
Total Medicare Allowed Amount |
57696.92 |
Total Medicare Payment Amount |
41494.51 |
Total Medicare Standardized Payment Amount |
42595.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
108 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
884 |
Total Drug Medicare AllowedAmount |
233.14 |
Total Drug Medicare PaymentAmount |
163.91 |
Total Drug Medicare Standardized Payment Amount |
163.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
867 |
Number Of Medicare Beneficiaries With Medical Services |
333 |
Total Medical Submitted Charge Amount |
95917.2 |
Total Medical Medicare Allowed Amount |
57463.78 |
Total Medical Medicare Payment Amount |
41330.6 |
Total Medical Medicare Standardized Payment Amount |
42431.21 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
299 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1266 |