National Provider Identifier [NPI]: |
1225222367 |
Last Name Of The Provider |
BEKKERS |
First Name Of The Provider |
ERIK |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5001 US HIGHWAY 30 W STE D |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468189701 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
2809 |
Number Of Medicare Beneficiaries |
2301 |
Total Submitted Charge Amount |
583350.36 |
Total Medicare Allowed Amount |
139412.87 |
Total Medicare Payment Amount |
108957.85 |
Total Medicare Standardized Payment Amount |
100633.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
92 |
Number Of Medical Services |
2809 |
Number Of Medicare Beneficiaries With Medical Services |
2301 |
Total Medical Submitted Charge Amount |
583350.36 |
Total Medical Medicare Allowed Amount |
139412.87 |
Total Medical Medicare Payment Amount |
108957.85 |
Total Medical Medicare Standardized Payment Amount |
100633.67 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
679 |
Number Of Beneficiaries Age 65 to 74 |
608 |
Number Of Beneficiaries Age 75 to 84 |
576 |
Number Of Beneficiaries Age Greater 84 |
438 |
Number Of Female Beneficiaries |
1313 |
Number Of Male Beneficiaries |
988 |
Number Of Non Hispanic White Beneficiaries |
2119 |
Number Of Black or African American Beneficiaries |
106 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
1316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
985 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.8237 |