National Provider Identifier [NPI]: |
1194712554 |
Last Name Of The Provider |
SCHUKA |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1005 MAR WALT DRIVE |
Street Address 2 Of The Provider |
FAMILY MEDICINE DEPARTMENT |
City Of The Provider |
FORT WALTON BEACH |
Zip Code Of The Provider |
325476796 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1709 |
Number Of Medicare Beneficiaries |
310 |
Total Submitted Charge Amount |
203177 |
Total Medicare Allowed Amount |
103284.48 |
Total Medicare Payment Amount |
70328.3 |
Total Medicare Standardized Payment Amount |
71286.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
577 |
Number Of Medicare Beneficiaries With Drug Services |
73 |
Total Drug Submitted ChargeAmount |
15267 |
Total Drug Medicare AllowedAmount |
8085.5 |
Total Drug Medicare PaymentAmount |
6441.58 |
Total Drug Medicare Standardized Payment Amount |
6441.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
1132 |
Number Of Medicare Beneficiaries With Medical Services |
310 |
Total Medical Submitted Charge Amount |
187910 |
Total Medical Medicare Allowed Amount |
95198.98 |
Total Medical Medicare Payment Amount |
63886.72 |
Total Medical Medicare Standardized Payment Amount |
64845.1 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
266 |
Number Of Black or African American Beneficiaries |
24 |
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 |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1767 |